Reorganization Of Sleep Patterns After Individual Surgical Treatment For OSAHS

ObjectiveTo investigate the character of sleep architecture for obstructive sleep apnea hypopnea syndrome(OSAHS)and give them individual surgical treatment according to their multiple obstructive parts.And to investigate the change of the sleep parameter,the reorganization of sleep architecture,the drowsiness and the reduce of the saturation of blood oxygen after the treatment.MethodsWe chose 40 moderate and severe patients who were finally diagnosed with OSAHS by polysomnography(PSG),electro-fibro laryngoscope and M(u|¨)ller test and all of them were consistent with the 2002 Hangzhou criteria.And we chose 40 primary snoring as the control group.All patients were performed individual surgical treatment after preoperative treatment with continuous positive airway pressure treatment(CPAP) 5-7 days.They filled the Epworth sleepiness scale with the special guidance.And they were given different surgical treatment according to their different obstructive parts.After 6 months of the surgery,they refilled the ESS, rechecked PSG and compared it to the previous results.Results1.Compared with the control group,the AHI,BMI,neck circumference, LSaO₂,MSaO₂,MAI,ESS,the superficial sleep time,the deep sleep time and the rapid eye movement of OSAHS are significantly different(P＜0.01).2.In the 40 cases(severe 30 and moderate 10)after the individual surgical treatment,healed 17.5%,utility 65%,improved 17.5%,no improved 0.3.After the operation,there is no significant change in BMI(P＞0.1),ESS was reduced from(14.60±3.70) to(8.32±2.22)(P＜0.01),and BMI was correlated with AHI(r=0.886).There is also an negative correlation between BMI and LSaO₂% (r=-0.742).We rechecked the PSG and found that AHI was reduced from (50.12±17.04) to(13.61±7.30).The lowest saturation of blood oxygen(LSaO₂) was increased from(70.02±9.66)%to(84.63±4.90)%,the Mean saturation of blood oxygen(MSaO₂) was increased from(92.03±2.95)%to(95.59±1.67)%(P＜0.01),the sleep efficiency was increased from(79.60±6.23) to(85.74±6.23).At the same time, the sleep architecture were effectively changed,the percent of S1 phase in total sleep time(TST) was reduced from(16.94±4.51)%to(10.86±5.64)%,the percent of S2 phase in total sleep time was reduced from(58.12±6.65)%to(50.69±7.13)%,the percent of S3+S4 phase in total sleep time was increased from(9.73±5.81)%to (17.51±8.21)%,the percent of REM phase was increased from(15.44±4.95)%to (21.37±5.31)%(P＜0.01).The Micro-arousal index was reduced from(38.42±19.32) to (14.31±8.88)(P＜0.01)and MAI was correlated with AHI(r=0.125).There is also an negative correlation between MAI and ESS(r=-0.735).Conclusions1.In the patients with moderate and severe OSAHS,the sleeping architecture is indiscriminate,the sleep gragmentation and the sleep cycle is insufficient,the superficial sleep time was extended,the deep sleep time and the rapid eye movement was decurtated or destitute,and the sleepiness is conspicuous aggravated.2.Individual surgical treatment for patients with moderate,severe OSAHS,the saturation of blood oxygen was significantly improved,the AHI and MAI were reduced,the percent of S1 and S2 phase were reduced,the percent of S3+S4 and REM were improved,the sleep architecture was also changed,and the sleep efficiency improved.So the individual surgical treatment is an effective method,and has a significant practical importance.