Abstract：
Respiratory arousal is the change from a state of sleep to a state of wakefulness following an apnea or hypopnea. In patients with obstructive sleep apnea (OSA), it could have a helpful role to activate upper airway muscles and the resumption of airflow and an opposing role to contribute to greater ventilatory instability, continue cycling, and likely exacerbate OSA. Patients with very severe OSA (apnea-hypopnea index (AHI) ≥ 60 events/h) may have specific chemical (e.g., possible awake hypercapnic hypoxemia) and mechanical (e.g., restricted dilator muscles) stimuli to initiate a respiratory arousal. Little was reported about how respiratory arousal presents in this distinct subgroup, how it relates to AHI, Epworth Sleepiness Scale (ESS), body mass index (BMI), and oxygen saturation, and how a non-framework surgery may change it. Here, in 27 patients with very severe OSA, we show respiratory arousal index was correlated with each of AHI, mean oxyhemoglobin saturation of pulse oximetry (SpO2), mean desaturation, and desaturation index, but not in BMI or ESS. The mean (53.5 events/h) was higher than other reports with less severe OSAs in the literature. The respiratory arousal index can be reduced by about half (45.3%) after a non-framework multilevel surgery in these patients.
摘要：
呼吸唤醒是在呼吸暂停或呼吸不足之后从睡眠状态到觉醒状态的变化。阻塞性睡眠呼吸暂停（OSA）患者，它可能有一个有益的作用，以激活上呼吸道肌肉和恢复气流和相反的作用，有助于更大的通气不稳定，继续骑自行车,并可能加剧OSA。患有非常严重OSA（呼吸暂停低通气指数（AHI）≥60事件/h）的患者可能具有特定的化学物质（例如，可能的清醒高碳酸血症低氧血症)和机械性(例如，受限的扩张器肌肉）刺激以引发呼吸唤醒。关于呼吸唤醒在这个独特的亚组中如何表现的报道很少，它与AHI的关系，Epworth嗜睡量表（ESS），体重指数（BMI），和氧饱和度,以及非框架手术如何改变它。这里,在27例严重OSA患者中，我们显示呼吸唤醒指数与每个AHI相关，平均血氧饱和度脉搏血氧饱和度（SpO2），平均去饱和，和去饱和指数，但不是在BMI或ESS中。平均（53.5事件/h）高于文献中其他严重OSA的报告。这些患者进行非框架多级手术后，呼吸唤醒指数可降低约一半（45.3％）。
