| The obstructive sleep apnea hypopnea syndrome (OSAHS) is a syndrome that appears upper airway constriction or obstruction repeatedly,Shortly,reversiblly during sleep.It can cause Sleep apnea, hypopnea and snoring sometimes,having a behavior of excessive sleepiness in the daytime.The snoring disease is what the loudness of snoring 60 db or more,it is an obstruction to breathing air through the upper airway and can affect the rest of roommate, or cause others trouble.Snoring is a very prominent symptoms of obstructive sleep apnea syndrome.Snoring and OSAHS is a very common and frequently-occurring disease in respiratory disorder and involvs people of all ages. Generally speaking , The incidence of OSAHS infants is 1% -3% and 2% -4% in adult while the elders is up to 20%-40%; and the prevalence rate of Snoring is 3%-48%.Snoring and OSAHS is that frequent apnea and hypopnea during sleep which can cause chronic intermittent hypoxia,hypercapnia,high negative pressure of thoracic cavity,repeatedly Micro awakens and anomaly Sleep textural ,and then lead to a series of clinical symptoms and complications,such as the disorder of autonomic nerve function, oxidative stress and inflammation reaction, injury of Vascular endothelial cell, increased blood viscosity, hypercoagulabale state, abnormal fibrinolytic system ,dysfunction of urinary ,generation and endocrine metabolic ,and so on . As a chronic and systemic disease, the OSAHS and Snoring was been taken seriously gradually, especially as an Independent hazard factor for cardio-cerebral vascular diseases, metabolic syndrome and so on ,it is a hotspot for research.Making a follow-up to the OSAHS patien without the treatment, He J etc find that the patien whose AHI>20 has a 5-year mortality 11%~13% compared with 37% for 8-year,however,those who have an treatment of the airway remodelling and continuous positive airway pressure has nobody died ,while 6 patients died after uvulopalatopharyngoplasty surgery (UPPP).It can be seen that OSAHS and Snoring influence people Seriously on Labor ability, the quality of life and survival, taking great economic burden to the society.Therefore, combined with investigation results in 2002 in chengde city, our research gives another 7 years fellow-up,to investigate the effect of snoring and OSAHS on human health,observe the incidence of different complications and mortality of snoring and non-snoring group during the 7 year follow-up and analyze the risk factors, compared with the untreated OSAHS patients sleep monitoring and Clinical characteristic,our study covers two parts:Part I: A 7-year follow-up study on non-snoring and snoring in ChengdePart II: Sleep monitoring characteristic analyses of obstructive sleep apnea-hypopnea syndrome after 7-year follow-upPart I: A 7-year follow-up study on non-snoring and snoring in ChengdeObjectiveTo investigate the effect of snoring on human health and observe the incidence of different complications and mortality of snoring and non-snoring group during the 7 year follow-up and analyze the risk factors,give a theory basis for the prevention and treatment of disease.MethodsThe subjects were conducted in the 2002 (1168 persons in total) in chengde city and to give a 7-year follow-up study. Snoring group were 298 people (including 27 deaths);non-snoring group were 764 people (including 24 deaths). There were 144 of non-snoring group to become snoring (snoring≥second degree).To compare the incidence of different complications and mortality of snoring and non-snoring group during the 7 year follow-up, and logistic regression analysis of risk factors of snoring on non-snoring group through 7-year follow-up,and the cognition of percentage of snoring (snoring is a disease and in need of treatment)between 2002 and 2009 years.Results1. The comparison of the incidence of complication between non-snoring group and snoring group through 7-year follow-up:The incidence of hypertension of non-snoring group and snoring group were 17.4% and 75.6% during the 7-year follow-up, there was a significant difference between the two group (P<0.01); the incidence of Coronary Heart Disease were 7.2% and 25.8% during the 7-year follow-up, there was a significant difference between the two group (P<0.01); the incidence of cerebrovascular disease were 5.7% and 21.8% during the 7-year follow-up, there was a significant difference between the two group (P<0.01); the incidence of diabetes mellitus were 4.2% and 19.2% during the 7-year follow-up, there was a significant difference between the two group (P<0.01); the incidence of Chronic kidney diseases were 0.5% and 4.1% during the 7-year follow-up, there was a significant difference between the two group (P<0.01).2. The comparison of the Mortality of different disease between non-snoring group and snoring group through 7-year follow-up:There were 51 cases with death, of which snoring group killed 27 people (9.06%), non-snoring group killed 24 people (3.87%), there was a significant difference between the two group (P<0.05).The Mortality of cancer were 2.3% and 0.6%,there was a significant difference between the two group (P<0.05); the Mortality of cerebrovascular disease were 3.7% and 1.0%,there was a significant difference between the two group (P<0.01); the Mortality of Cardiovascular Disease were 3.0% and 1.5%,there was no significant difference between the two group (P>0.05).3. Logistic regression analysis of risk factors of snoring on non-snoring group through 7-year follow-up:the relationship between family history of snoring, smoke index, body mass index and the occurrence of snoring was significantly (P <0.01), the relationship between age and the occurrence of snoring was significantly (P <0.05).4. In all of the people surveyed,only 23.44 percent have an aware that snoring is a disease needed treatment in 2009, and 25.34 percent have an aware in 2002, there was a significant difference between the two surveys.ConclusionSnoring is risk factors of hypertension, coronary heart disease, cerebrovascular disease, diabetes and chronic kidney disease such as disease.The mortality of Snoring group was significantly higher than non-snoring.The risk factors of snoring were family history of snoring, smoke index, body mass index and age.There was no significant improvement in cognition that snoring is a disease needed treatment.Therefore, we should do is to strengthen publicity and education work.Part II: Sleep monitoring characteristic analyses of obstructive sleep apnea-hypopnea syndrome after 7-year follow-upObjective To analyze whether the patients with untreated OSAHS have sleepmonitoring and clinical characteristics change through 7-year follow-up.MethodsGiving the 99 OSAHS patients another follow up,monitoring there Sleep and Respiration and analyzing there clinical characteristics. The 99 untreated OSAHS patients were diagnosed with a portable sleep monitor 7 years ago including 63 cases of young adul(tmale 45,female 18)and 36 aged(male 22,female 14).Results1. The comparison of the severity degree and clinical characteristic of OSAHS of between middle-aged group and elderly group through 7-year follow-upThe prevalence of wakefulness during nighttime of middle-aged group was significantly higher than elderly group, there was a significant difference (P<0.05). There was no significant difference on the prevalence of Sleepiness during daytime of middle-aged group and elderly group(P>0.05).The prevalence of hypertension of elderly group was significantly higher than middle-aged group, there was a significant difference between the two group (P<0.05).The prevalence of coronary heart disease,cerebrovascular disease and diabetes mellitus of elderly group was significantly higher than middle-aged group, there was a significant difference between the two group (P<0.01).The severity of patients with OSAHS 0f middle-aged group significantly increased compared with seven years ago, there was a significant difference(P<0.01); The severity of patients with OSAHS 0f elderly group increased compared with seven years ago, but there was no significant difference(P>0.05).2. The comparison of the of OSAHS of sleep monitoring indicatrix between middle-aged group and elderly group through 7-year follow-up(1) Comparison of anterior-posterior itselfThrough 7-year follow-up,middle-aged group of OSAHS patients of sleep apnea-hypopnea index (AHI) from 21.7 times / h increased to 30.2 times / h, body mass index (BMI), ESS score was significantly increased,the lowest oxygen saturation during sleep (L SaO2) decreased significantly,compared with seven years ago,there was a significant difference(P<0.01).Through 7-year follow-up, elderly group of OSAHS patients of sleep apnea-hypopnea index (AHI) from 25.6 times / h increased to 30.7 times / h, there is increasing trend in body mass index, ESS score had to reduce trend,compared with seven years ago,but there was no significant difference(P>0.05);the lowest oxygen saturation during sleep (L SaO2) decreased significantly,compared with seven years ago,there was a significant difference(P<0.01).(2) Comparison of interclass changed values Through 7-year follow-up,the changed AHI of middle-aged group of OSAHS patients was significantly higher than elderly group,there was a significant difference(P<0.01); the changed lowest oxygen saturation during sleep (L SaO2) of middle-aged group of OSAHS patients was significantly higher than elderly group,there was a significant difference(P<0.01).ConclusionThe degree of sleep disorders of middle-aged untreated OSAHS patients gradually aggravate along with age,and the degree of sleep disorders of elderly untreated OSAHS patients with progression tendency to some extent slow down,but the prevalence of complications such as cardiovascular and cerebrovascular disease obviously increased.Obstructive sleep apnea-hypopnea syndrome is a potentially progressivity disease,and we should early treatment and delay pathogenesis progression and decrease occurrences of the complication.
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