睡眠時無呼吸症と指尖血流量

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Polysomnographic recordings during spontaneous nocturnal sleep were made in 16 pa- tients (age range,3 to 60 years) suffering from sleep apnea and snoring. Continuous recor- dings of fingertip blood flow, mesopharyngeal pressure amplitude, arterial oxygen saturation, air flow and thoracic movement were made simultaneously. Sleep apnea syndrome (SAS) was diagnosed in cases scoring more than 5 on the apnea index based on the proposal of Guilleminault et al. Seven of 16 cases were diagnosed as SAS. Four cases in this group showed an obstructive type of SAS, and 3 cases exhibited a mixed type. Fifteen of 16 patients showed an irregular transient decrease in fingertip blood flow during the non-apneic period and a regular decrease about 3 seconds after ventilatory resumption during the apneic period. The remaining patient showed an unstable blood flow continuously. How a transient decrease in fingertip blood flow relates to ventilation during sleep is unclear. This transient decrease was referred to as a'dip phenomenon of blood flow (DBF)'. The frequency of DBF in an hour was defined as the DBF index, and a statistical analysis of DBF index was performed. The DBF index in the SAS group was found to be higher than that in the non-SAS group. The difference was considered statistically significant. SAS patients had more frequent episodes of DBF compared to non-SAS subjects. It was suggested that a higher tension of the sympathetic nervous system occurs in the SAS patients. Significant increase in the DBF index was detected with decreasing SaO2 (p<0.05), while no relation was found between the DBF index and mesopharyngeal pressure amplitude. The results demonstrated that peripheral blood flow is affected by pulmonary dysfunction in patients with upper airway obstruction.
耳鼻咽喉科臨床学会の論文

睡眠時無呼吸症と指尖血流量

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