Artigo Original/Original Article
Características clínicas e polissonográficas de doentes com distúrbio respiratório do sono em REM
Clinical and polysomnographic characteristics of patients with REM sleep disordered breathing
1 Interna Complementar de Pneumologia, Serviço de Pneumologia dos Hospitais da Universidade de Coimbra/Resident, Pulmonology, Pulmonology Unit, Hospitais da Universidade de Coimbra
2 Assistente Hospitalar de Pneumologia, Serviço de Pneumologia do Hospital de São João, Porto/Consultant, Pulmonology, Pulmonology Unit, Hospital de São João, Porto
3 Professor da Faculdade de Medicina da Universidade do Porto, Serviço de Pneumologia do Hospital de São João, Porto/University of Porto School of Medicine, Pulmonology Unit, Hospital de São João, Porto
4 Chefe de Serviço do Hospital de São João, Porto/Unit Head, Hospital de São João, Porto
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Estudos anteriores têm sugerido, nestes doentes, um aumento de prevalência de distúrbios psiquiátricos, bem como um efeito da idade e do género.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Propusemo-nos, por isso, estudar as características clínicas e polissonográficas de doentes com o referido diagnóstico.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Os critérios de inclusão foram a identificação de SAOS em REM, por polissonografia (PSG), definida como IAH em REM ≥<span class="elsevierStyleHsp" style=""></span>5/h, IAH em sono não REM (NREM)<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>15/h, IAH REM/NREM<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2. Foram ainda analisados alguns parâmetros do <span class="elsevierStyleItalic">sleep disorders questionnaire</span> (SDQ) versão 1.02, nomeadamente os relacionados com ansiedade ou depressão. Foram estudados 19 doentes com média de idades de 54,0 anos (SD 13,97) e média de IMC de 29,01 (SD Dev 4,10). A razão entre género feminino/masculino foi de 0,58. O valor médio da escala de Epworth foi de 12,74 (SD 4,86). Em relação à gravidade da SAOS, a média do IAH foi de 9,16/h (SD 4,09) e a do IAH em REM de 37,08/h (SD 25,87). Para a relação IAH-REM/IAH-NREM obtivemos a média de 8,86 (SD 8,63).</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">A prevalência do distúrbio de ansiedade foi de 33,3% (44,4% no sexo feminino e 16,7% no sexo masculino). Na população estudada, o tempo de sono profundo foi de 20,7% (SD 10,42) e de sono REM de 15,45% (SD 9,96), com uma eficiência de sono de 85,3% (SD 8,70).</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Não se verificou qualquer correlação estatisticamente significativa entre o índice de IAH REM/NREM e a sintomatologia ansiosa, a sonolência diurna e a qualidade do sono (percentagem de sono profundo e de sono REM). Concluímos que a subpopulação estudada apresenta características que divergem das descritas para a população com SAOS; em média, não são doentes obesos, as mulheres são mais afectadas, a sintomatologia não é tão exuberante, nomeadamente a hipersonia diurna. Observa-se, também, uma redução do sono profundo e um aumento do sono REM neste grupo de doentes <span class="elsevierStyleItalic">versus</span> a população geral, estando a eficiência do sono no limite inferior da normalidade. Ainda o distúrbio de ansiedade apresenta maior prevalência em relação à descrita para a população geral (3%) e em relação à descrita para a população com SAOS.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (5): 847-857</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">There is a 10-36% rate of obstructive sleep apnoea syndrome (OSAS) associated with rapid eye movement (REM) in the OSAS population. Prior studies have suggested an increased prevalence of psychiatric disorders and an effect of gender and age on these patients.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">Our aim was to study the clinical and polysomno-graph (PSG) characteristics of our patients with REM-related sleep disordered breathing (REM SDB).</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">Inclusion criteria was the identification of REM SDB detected by PSG defined as apnea-hypopnea index (AHI) in REM sleep ≥<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>h, AHI in non-REM sleep (NREM)<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>h and REM/NREM AHI ≥<span class="elsevierStyleHsp" style=""></span>2.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Several Sleep Disorders Questionnaire (SDQ) version 1.02 parameters were analysed.</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">The study comprised 19 patients with a mean age of 54.0 (SD<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.97), a mean BMI of 29.01 (SD<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.10) and a 0.58 female / male ratio. The mean Epworth Sleepiness Scale score was 12.74 (SD ±<span class="elsevierStyleHsp" style=""></span>4.86). Mean AHI was 9.16/h (SD 4.09); mean AHI in REM sleep 37.08/h (SD 25.87) and mean REM-AHI/NREM-AHI 8.86 (SD 8.63).</p><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">The anxiety disorder rate was 33.3%; 44.4% in females, 16.7% in males.</p><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall">The average deep sleep was 20.7% (SD 10.42) and REM sleep 15.45% (SD 9.96), with a sleep efficiency of 85.3 (SD 8.70).</p><p id="sp0070" class="elsevierStyleSimplePara elsevierViewall">No significant statistical correlation was found between the REM/NREM AHI index and anxiety symptoms, daytime sleepiness and sleep quality (REM and deep sleep percentages).</p><p id="sp0075" class="elsevierStyleSimplePara elsevierViewall">These patients differ from the general OSAS population: on average, they are not obese, there are a greater number of females affected and they do not present a very significant diurnal hypersomnia. Reduced deep sleep and increased REM sleep were also present versus general population data, and sleep efficiency was just below the normal limit.</p><p id="sp0080" class="elsevierStyleSimplePara elsevierViewall">Anxiety disorders were more prevalent in this group than described for the general population (3%) and OSAS patients.</p><p id="sp0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (5): 847-857</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia/Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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La Forge" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/141.6.1522" "Revista" => array:7 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1990" "volumen" => "141" "numero" => "6" "paginaInicial" => "1522" "paginaFinal" => "1526" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2350095" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upper airway muscle activity in normal women: influence of hormonal status" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Popovic" 1 => "D. White" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Appl Physiol" "fecha" => "1998" "volumen" => "84" "paginaInicial" => "1055" "paginaFinal" => "1062" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9480969" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001500000005/v1_201509151448/S0873215915301811/v1_201509151448/pt/main.assets" "Apartado" => array:4 [ "identificador" => "9575" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Artigos originais" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001500000005/v1_201509151448/S0873215915301811/v1_201509151448/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301811?idApp=UINPBA00004E" ]
Article information
ISSN: 08732159Original language: Portuguese
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