SUAT AVCI, AYNUR YILMAZ AVCI, Berna Devrim YAĞBASAN, Hüseyin GÜNİZİ

Obstrüktif uyku apnesinde oksijen satürasyonunun %90-95 altında kaldığı durumlarda uyku süresi ile klinik ve laboratuvar bulguları arasındaki ilişki

Obstrüktif uyku apnesinde oksijen satürasyonunun%90-95 altında kaldığı durumlarda uyku süresi ile klinikve laboratuvar bulguları arasındaki ilişki Amaç: Bu çalışmanın amacı obstrüktif uyku apnesinde (OUA); CT90veCT95değerleri ile fizik muayene parametreleri, kronik metabolik hastalıklar, sigara içimi, ortalama trombosit hacmi, beyin manyetik rezonansgörüntülemesinde (MRG) hiperintens odak varlığı ve sayısı arasındakiilişkileri saptamaktı. Yöntem:Hastanemiz uyku laboratuvarında 2011-2014 tarihleri arasında polisomnografi uygulanan 1154 olgu retrospektif olarak tarandı. Bu hastalardan kulak burun boğaz muayenesi yapılmış, beyinMRG, CBC ve biyokimya tetkikleri bulunan 72 olgu çalışmaya dahiledildi. Tüm hastalarda ayrıntılı anamnez ile birlikte (1) Vücut kitle indeksi (VKİ), (2) boyun ve karın çevresi ölçümü, (3) orofarenks muayenesi, (4) fiberoptik endoskop ile Müller manevrası uygulaması, (5) Epworth uyku skalası ve (6) polisomnografi (PSG) tetkikleri yapıldı. Bulgular:Olguların OUA şiddetine göre dağılımı: %22.2 basit horlama,%19.4 hafif, %19.4 orta ve %38.9 ağır OUA idi. Çoklu doğrusal regresyonanalizi yapıldığında apne-hipopne indeksi (AHİ) (p=0.026) ve vücut kitleindeksinin (VKİ) (p=0.013) CT90'ı etkileyen bağımsız değişkenler olduğu(R2=%49) görüldü. Çoklu doğrusal regresyon analizi yapıldığında sigaraiçimi (p=0.001), AHİ (p=0.003) ve hiperintens odak sayısının (p=0.013)CT95'i etkileyen bağımsız değişkenler olduğu (R2=%47.9), diyabet ve VKİile CT95ilişkisinin istatistiksel olarak anlamlı olmadığı görüldü. Sonuç:CT95değerinin sigara içiminden etkileniyor olması, ancak retropalatal ve retroglossal Müller evreleri ile istatistiksel anlamlı ilişkisi bulunmaması nedeniyle, obstrüktif uyku apnelilerde kronik entermitan hipoksi şiddetinin değerlendirilmesinde CT90değerinin dikkate alınmasının daha uygun olduğu düşünülmüştür. Bununla birlikte CT90değerininAHİ ile korelasyonu ST90için literatürde belirtilen değere yakın, ancakdaha güçlü değildir

The relationship between clinical and laboratory findings and duration of sleep where oxygen saturation remains below 90-95% in obstructive sleep apnea

Objective:The aim of the present study was to determine correlationsbetween CT90and CT95values and physical examination parameters,chronic metabolic diseases, smoking, mean platelet volume, cerebralmagnetic resonance imaging (MRI), presence and number of hyperintense foci in obstructive sleep apnea (OSA). Methods:A total of 1154 patients who underwent polysomnography inour sleep laboratory between 2011 and 2014 were screened retrospectively. Among them, 72 cases who underwent ear, nose and throat examinations, cerebral MR, CBC and biochemical tests were included in thestudy. All patients underwent a detailed anamnesis together with (1)measurements of BMI (body mass index) (2) circumferences of neck andabdomen, (3) examination of oropharynx, (4) Müller maneuver with theaid of fiberoptic endoscope, (5) estimation of Epworth sleep scale scores,(6) and polysomnographic (PSG) tests. Results: According to the severity of OSA, the patients had simple snoring (22.2%), mild (19.4%) and severe OSA (38.9%). In multivariateregression analysis, body mass index (BMI) (p=0.026) and apnea/hypopnea index (AHI) (p=0.013) were seen as independent variables affectingCT90(R2=49%). Multivariate linear regression analysis demonstrated thatindependent variables of smoking (p=0.001), AHI (p= 0.003) and numberof hyperintense foci (p=0.013) affected CT95(R2=%47.9), while relationships between diabetes, BMI and CT95were not statistically significant. Conclusion:Since CT95values are affected by smoking without any statistically significant correlation with retropalatal and retroglossal Müllerstages, we think that consideration of CT90value will be more appropriatein the evaluation of the severity of chronic intermittent hypoxia in patientswith obstructive sleep apnea. However, the correlation between CT90valueand AHI is closer to the value indicated in the literature, but not stronger

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