Mustafa ERELEL, Fatih YAKAR, Aysun YAKAR, Murat SEZER

Role of daytime polysomnography in the diagnosis of sleep apnea syndrome

Giriş: Uyku apne sendromu (UAS) tanısı gece boyu süren polisomnografiyle (PSG) konmaktadır, ancak test için bekleme süresi oldukça uzundur. Gündüz aşırı uykululuğu bulunan hastalarda gündüz PSG yapılabileceği önerilmiştir ancak testin nasıl, ne kadar süreyle yapılacağı ve tanıdaki rolü konusunda net bilgi yoktur. Bu çalışmanın primer amacı gündüz yapılacak PSG'nin uyku apne sendromu tanısını koymadaki rolünü saptamak, sekonder amacıysa gündüz-gece PSG leri arasında korelasyon olup olmadığını belirlemektir. Hastalar ve Metod: Gündüz aşırı uykululuk hali olan ve uyku laboratuvarına polismonografi yapılmak üzere gönderilmiş 48 hasta cross-over çalışmaya alındı. Hastaların yarısına önce gece PSG daha sonra gündüz PSG yapılırken diğer gruba önce gündüz PSG daha sonra gece PSG yapıldı. Yedi hasta PSG çalışmasına katılmadığı için çalışmadan çıkarıldı. Polisomnografi kayıt ve analizleri AASM 2007 kılavuzuna göre gerçekleştirildi. Sonuçlar uyku etkinliği, RDI, UAS ağırlığı, oksijen desaturasyon indeksi (ODİ), gece ve gündüz PSG arasında tanı korelasyonu açısından değerlendirildi. Bulgular: Toplamda 41 hasta analize alındı. Tüm hastalara UAS tanısı kondu. Gece PSG'de uyku etkinliği daha yüksek (%86) saptansa da gündüz PSG'de de yeterli etkinlik (%80) saptandı. Uykunun evreleri arasında gece PSG ve gündüz PSG arasında Evre 3 anlamlı fark yoktu (p> 0.05). Gece PSG'de daha fazla Evre 3 görüldü. Önce gece veya gündüz PSG yapılmasının uyku etkinliği, RDI, ODİ ve UAS nin ağırlıyla ilişkisi olmadığı saptandı. Vücut kitle indeksi RDI, ODİ ve UAS ağırlığıyla ilişkili bulunmazken; boyun çevresi yakın ilişkili bulundu (p< 0.05). Sonuç: Gündüz PSG uygun şekilde yapıldığında, gündüz aşırı uykululuğu olan hastalarda UAS tanısını koymada etkili bir yöntemdir. Gündüz PSG yapılarak hastaların test için bekleme süreleri azalabilir.

Uyku apne sendromu tanısında gündüz polisomnografinin rolü

Role of daytime polysomnography in the diagnosis of sleep apnea syndrome Introduction: Diagnosis of sleep apnea syndrome (SAS) depends on nocturnal polysomnography (nPSG), but waiting time for the test is long. Although, performing PSG in patients with excessive daytime sleepiness (EDS) at daytime (dPSG) was questioned, role and methods are not clear. The aim of the study was to assess the role of dPSG in the diagnosis of SAS, and the correlation between nPSG and dPSG. Patients and Methods: Forty eight subjects, who were referred to our sleep laboratory with EDS were included to a cross-over study. Half of the patients underwent nPSG after dPSG, vice versa. Seven subjects excluded due to lack of participation. The rest (n= 41) had nPSG and dPSG. PSG recordings and analysis were performed according to AASM 2007 guideline. Results were analyzed for sleep efficiency, respiratory disturbance index (RDI), oxygen desaturation index (ODI), SAS severity and correlation between dPSG and nPSG. Results: Total 41 subjects were analyzed. All patients had diagnosis of SAS. Sleep efficiency was higher at nPSG (86%), however also enough at dPSG (80%). Sleep stages of dPSG and nPSG were similar except stage 3 sleep, which was longer at nPSG. Undergoing dPSG or nPSG first did not correlate with sleep efficiency, respiratory disturbance (RDI) index, oxygen desaturation index (ODI) or severity of SAS. Despite BMI, neck circumference was closely related with RDI, ODI and severity. Conclusion: Daytime PSG, when performed appropriately, is an effective tool for diagnosing sleep disorders in patients with EDS. dPSG may decrease the amount of times that patients must wait to undergo PSG.

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