Objective To compare the parameters of polysomnography (PSG) in sleep structure and respiratory events between dexmedetomidine-induced sleep and natural sleep. Methods From April 2016 to September 2018, a total of 44 patients with obstructive sleep apnea (OSA) and 3 patients with simple snoring completed PSG monitor both in natural sleep and dexmedetomidine-induced sleep in Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tsinghua Changgung Hospital. The PSG parameters were statistically analysed with SPSS 22.0 software. Results The average dose of dexmedetomidine was (104.60±27.93)μg, and there was no significant difference between the induced-sleep efficiency and the natural sleep efficiency (82.14％± 16.66％ vs. 86.50％± 9.18％, t=-1.559, P>0.05). There was no rapid eye movement(REM) stages in all 47 subjects and only 1 case of them had non-rapid eye movement(NREM) stage 3 in induced sleep. The percentage of NREM1 in total sleep time was statistically different between the two groups (42.10％±26.71％vs. 17.47％±11.68％, t=5.997, P<0.001),but there was no significant difference in the percentage of NREM2 in total sleep time between the two groups (56.96％±26.0％vs. 62.95％±9.03％, t=-1.521, P=0.135). About respiratory events, there were significant differences in apnea hypopnea index ((46.29±20.23)/h vs. (39.67±25.41)/h), obstructive apnea index (25.20[10.50,45.40]/h vs. 16.20[3.30,35.20]/h) between induced-sleep and natural sleep (t=2.297, Z=-3.008, all P<0.05), these difference were more significant in mild-to-moderate OSA. There were no statistically significant differences in central apnea index (0.00[0.00, 2.80]/h vs. 0.40[0.10, 1.20]/h), mixed apnea index (0.00[0.00, 6.20]/h vs. 0.00[0.00, 3.40]/h, hypopnea index (4.20[0.00, 3.30]/h vs. 12.00[5.20, 17.40]/h), Z=-0.110,-0.508,-1.544, all P>0.05). There were statistical differences in the lowest oxygen saturation (84.77％± 7. 59％vs. 80.21％± 11.62％, t=2.558, P=0.014). Conclusions There is no significant difference in sleep efficiency and NREM2 between dexmedetomidine induced sleep and natural sleep.NREM3 sleep is rare induced, but REM sleep is none of all. And dexmedetomidine induced sleep may aggravate obstructive sleep apnea, but not central apnea.%目的 对比分析右美托咪定诱导睡眠下的多道睡眠监测(PSG)睡眠结构及呼吸事件与自然睡眠下PSG各项参数的差异.方法 选取2016年4月至2018年9月于北京清华长庚医院耳鼻咽喉头颈外科行右美托咪定诱导睡眠的44例阻塞性睡眠呼吸暂停(OSA)患者和3例单纯打鼾患者,同期进行PSG监测,比较与自然睡眠状态下PSG呼吸事件、睡眠结构的各项参数变化.采用SPSS 22.0软件进行统计学分析.结果 右美托咪定的平均使用剂量为(104.60±27.93)μg.诱导睡眠有效率与自然睡眠有效率差异无统计学意义(82.14％±16.66％比86.50％±9.18％,t=-1.559,P>0.05).47例受试者在诱导睡眠下均无快速眼动(REM)期出现,仅有1例出现非快速眼动(NREM)3期;NREM1期占睡眠时间的百分比在两组间差异有统计学意义(42.10％±26.71％比17.47％±11.68％,t=5.997,P<0.001),NREM2期占睡眠时间的百分比在两组间差异无统计学意义(56.96％±26.06％比62.95％±9.03％,t=-1.521,P=0.135).呼吸事件方面,诱导睡眠与自然睡眠中出现的呼吸暂停低通气指数[(46.29±20.23)次/h比(39.67±25.41)次/h]、阻塞性呼吸暂停指数(25.20[10.50,45.40]次/h比16.20[3.30,35.20]次/h)差异均有统计学意义(t=2.297,Z=-3.008,P值均<0.05),以上差异主要体现在轻中度OSA患者中.而中枢性呼吸暂停指数(0.00[0.00,2.80]次/h比0.40[0.10,1.20]次/h)、混合性呼吸暂停指数(0.00[0.00,6.20]次/h比0.00[0.00,3.40]次/h)、低通气指数(4.20[0.00,3.30]次/h比12.00[5.20,17.40]次/h)差异均无统计学意义(Z=-0.110、-0.508、-1.544,P值均>0.05);最低动脉血氧饱和度差异有统计学意义(84.77％±7.59％比80.21％±11.62％,t=2.558,P=0.014).结论 右美托咪定诱导睡眠在睡眠有效率、NREM2期占睡眠时间的百分比方面与自然睡眠无明显差异,极少出现NREM3期睡眠,未能诱导出REM期睡眠.右美托咪定诱导睡眠可能加重OSA程度,但不会增加OSA患者的中枢性呼吸暂停.
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