Pozisyonel ve nonpozisyonel obstrüktif uyku apne sendromu hastalarının antropometrik, demografik, polisomnografik ve klinik özelliklerinin karşılaştırılması
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Dosyalar
Tarih
2011
Yazarlar
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
GİRİŞ ve AMAÇ: OUAS ?Uykuda tekrarlayan üst solunum yolu (ÜSY) tıkanmaları ile karakterize ve sıklıkla oksijen desatürasyonları ile birliktelik gösteren bir sendrom? olarak tariflemiştir. Erkeklerde %3.9 kadınlarda %1.2 olmak üzere oldukça sık görülmektedir.Bu çalışmayla Pozisyonel (P) ve Nonpozisyonel (NP) OUAS hastalarının antropometrik, demografik, polisomnografik ve klinik özelliklerini karşılaştırılarak P ve NP OUAS arasında anlamlı farklılıklar gösterilebilirse bu grup hastaların tedavi ve takiplerinde olası farklı yaklaşımların klinisyenlerin dikkatine sunulması amaçlanmıştır.YÖNTEM: Düzce Üniversitesi Tıp Fakültesi Uyku laboratuarında 4 yıl boyunca Polisomnografik tetkik ile Obstrüktif Uyku Apne Sendromu tanısı alan ardışık 108 olgunun kayıtları retrospektif olarak hastalığın pozisyonla ilişkisi açısından yeniden değerlendirildi.BULGULAR: Olguların 76'sı erkek, 32'si kadındı. OUAS majör semptomları sorgulandığında olguların %98.1inde (106/108) horlama olduğu, %89.6'sında ise (95/106) bu horlamanın habitüel olduğu tespit edildi. Gündüz aşırı uykululuk hali %79.6'sında (82/103), tanıklı apne %81'inde (85/105) tesbit edildi. OUAS hastalarının 26'sı Pozisyonel OUAS (%24,1), 82 tanesi Nonpozisyonel OUAS (%75,9) olarak tespit edildi. NP OUAS'lu olguların yaş ortalaması 50.1, kilo ortalaması 88.5, boy oratalaması 165.5, BMI ortalaması 32.5, boyun genişliği ortalaması 41.2, P OUAS'li olguların yaş ortalaması 49.6, kilo ortalaması 94.3, boy oratalaması 173.4, BMI ortalaması 31.6, boyun genişliği ortalaması 41.6 olarak tesbit edildi. P grubunun boy ortalaması (173.4cm), NP grubunun boy ortalamasından (164.9cm) istatistiksel anlamlı olarak daha yüksek bulundu. P ve NP grupları AHİ yönünden karşılaştırıldığında P grubunda AHİ'nin anlamlı olarak daha düşük olduğu tespit edildi. P ve NP grupları karşılaştırıldığında P OUAS grubun istatistiksel anlamlı olarak erkek ağırlıklı olduğu görüldü. P ve NP OUAS olgularında tek değişkenli analiz yöntemleri ile anlamlı bulunan cinsiyet, AHİ ve boy kullanılarak yapılan lojistik regresyon analizinde P OUAS oluşumuna etki eden tek bağımsız risk faktörünün boy olduğu tespit edildi.SONUÇ: Göğüs Hastalıkları kliniklerine ve uyku merkezlerine başvuran OUAS klinik semptomları belirgin olan uzun boylu hastalara polisomnografi tetkiki için uzun süreli randevu verilecekse bu sürede hastaların tedavisiz kalmaması ve hastalığının şiddetinin artmaması için pozisyon tedavisi önerilebilir.Pozisyonel ve Nonpozisyonel OUAS'lu hastalara klinisyenlerin yaklaşımlarını yönlendirecek antropometrik, demografik, polisomnografik ve klinik özellikleri araştıran ve özellikle Pozisyonel OUAS ile uzun boy ilişkisini açıklayacak daha büyük çaplı prospektif çalışmalara gereksinim vardır.ANAHTAR KELİMELER: pozisyonel obstruktif uyku apne sendromu, uyku apne, pozisyonel uyku apne, uyku apne tedavisi, boy
BACKGROUND and AIM: OSAS is defined as ?a syndrome which characterized by repeated upper air way tract obstruction and associated with oxygen desaturation?. It is prevalent of 3.9% in female and 1.2% in male population.In the present study, it was aimed to compare clinical, anthropometric, demographic and polysomnographic features between patients with Positional (P) and Non-positional (NP) OSAS, and present different treatment approaches and follow-up in both group patients depending on results of our study to clinicians.METHODS: Medical records of 108 consecutive patients with OSAS diagnosed by polysomnographic tests since 4 years in Sleep Laboratory of School of Medicine, Cheat Disease Department, Duzce University, were retrospectively re-evaluated with patients? positional relationRESULTS: 76 and 32 of all subjects was male and female, respectively. There was symptom of snoring in 98.1% of patients (106/108), and it was detected that snoring in 89.6% (95/106) of patients presented with snoring was habitual. Daylight somnolence (82/103), apnea (85/105) which confirmed by someone was detected in 79.6% and 81% of subjects.26 (24.1%) and 82 (75.9%) patients with OSAS was P- and NP-OSAS. In patients NP-OUAS, mean age, weight, height, body mass index and neck circumference were 50.1, 88.5, 165.5, 32.5 and 41.2. In patient with P-OSAS, mean age, weight, height, body mass index and neck circumference were 49.6, 94.3, 173.4, 31.6 and 41.6. Mean height in patients with P- OSAS was found to be significantly higher than in NP- OSAS. When AHI was compared between patients with P- and NP- OSAS, AHI was significantly lower in patients with P-OSAS. The number of male patients in P-OSAS was significantly higher. With logistic regression analysis, it was detected that height was independent risk factor for P-OSAS among gender, AHI and height confounding factors.CONCLUSION: Position treatment could advised to tall patients presented with symptoms related to OSAS, admitted to outpatient clinic of chest diseases and sleep disorder center, and to prevent to worsen his/her symptom when appointment for polysomnography tests would be dated forward.Comprehensive prospective studies on anthropometric, demographic, polysomnographic and clinical features in patients with NP-OSAS and P-OSAS, especially relation between tall height and P-OSAS, are needed.
BACKGROUND and AIM: OSAS is defined as ?a syndrome which characterized by repeated upper air way tract obstruction and associated with oxygen desaturation?. It is prevalent of 3.9% in female and 1.2% in male population.In the present study, it was aimed to compare clinical, anthropometric, demographic and polysomnographic features between patients with Positional (P) and Non-positional (NP) OSAS, and present different treatment approaches and follow-up in both group patients depending on results of our study to clinicians.METHODS: Medical records of 108 consecutive patients with OSAS diagnosed by polysomnographic tests since 4 years in Sleep Laboratory of School of Medicine, Cheat Disease Department, Duzce University, were retrospectively re-evaluated with patients? positional relationRESULTS: 76 and 32 of all subjects was male and female, respectively. There was symptom of snoring in 98.1% of patients (106/108), and it was detected that snoring in 89.6% (95/106) of patients presented with snoring was habitual. Daylight somnolence (82/103), apnea (85/105) which confirmed by someone was detected in 79.6% and 81% of subjects.26 (24.1%) and 82 (75.9%) patients with OSAS was P- and NP-OSAS. In patients NP-OUAS, mean age, weight, height, body mass index and neck circumference were 50.1, 88.5, 165.5, 32.5 and 41.2. In patient with P-OSAS, mean age, weight, height, body mass index and neck circumference were 49.6, 94.3, 173.4, 31.6 and 41.6. Mean height in patients with P- OSAS was found to be significantly higher than in NP- OSAS. When AHI was compared between patients with P- and NP- OSAS, AHI was significantly lower in patients with P-OSAS. The number of male patients in P-OSAS was significantly higher. With logistic regression analysis, it was detected that height was independent risk factor for P-OSAS among gender, AHI and height confounding factors.CONCLUSION: Position treatment could advised to tall patients presented with symptoms related to OSAS, admitted to outpatient clinic of chest diseases and sleep disorder center, and to prevent to worsen his/her symptom when appointment for polysomnography tests would be dated forward.Comprehensive prospective studies on anthropometric, demographic, polysomnographic and clinical features in patients with NP-OSAS and P-OSAS, especially relation between tall height and P-OSAS, are needed.
Açıklama
YÖK Tez No: 282065
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases, Antropometri, Anthropometry, Boy, Body height, Demografi, Demography, Tedavi, Treatment, Uyku, Sleep, Uyku apne sendromları, Sleep apnea syndromes, Uyku bozuklukları, Sleep disorders, positional obstructive sleep apnea syndrome, sleep apnea, positional sleep apnea, treatment, height
