Objective:To investigate the effects of adaptive servo-ventilation(ASV) on the residual sleepiness(RS) in patients with obstructive sleep apnea syndrome(OSAS). Methods:Following correct application of one month’s auto-CPAP(APAP) treatment and exclusion for other sleepiness-associated disorders, 42 RS patients with moderate-to-severe OSAS were recruited. All of them received one week’s ASV treatment with auto CS2 ventilator. 24 patients with RS after 1 month’s treatment with APAP were recruited as the control group, which went on receiving one week’s treatment with APAP. Comparisons were made between APAP and ASV treatment group concerning the following parameters: polysomnographic parameters including apnea hypopnea index(AHI), central sleep apnea index(CSAI), micro-arousal index(MAI), minimal pulse oxygen saturation(mini SpO2), daytime Epworth sleepiness score(ESS); and plasma tumor necrosis factor-α(TNF-α) which is one of possibly sleepiness-associated factor. Comparisons were also made at the same time point in control group. Plasma TNF-α levels were measured by enzyme linked immunosorbent assay(ELISA). Results: Compared with the parameters at the end of one month’s APAP treatment, there was a further significant decrease in AHI, CSAI, MAI, daytime ESS and plasma TNF-α levels(P < 0.01) at the end of one week’s ASV treatment in RS group. ESS before ASV treatment(9.81 ± 0.59) returned to normal range(3.98 ± 1.26) following ASV treatment(P < 0.01). Only was mean SpO2 higher in the control group than in the ASV treatment group(P < 0.05). Conclusion:ASV treatment could significantly improve RS in OSAS patients, the mechanism might be associated with declined levels of CSAI and TNF-α.
姚苏梅,张希龙.匹配伺服通气对阻塞性睡眠呼吸暂停患者残余嗜睡疗效的研究[J].南京医科大学学报(自然科学版英文版),2008,28(3):376-379.