■Catathrenia是一种罕见的睡眠障碍,其特征是在长时间的呼气期间反复夜间呻吟。患有Catathrenia的患者有异质性多导睡眠图,合并症,颅面特征,以及对治疗的反应。识别疾病的表型可能有助于探索病因和个性化治疗。
■66例经全夜音频/视频多导睡眠图诊断患有下颌前移装置(MAD)或持续气道正压通气(CPAP)治疗的患者被纳入队列。多导睡眠特征,包括睡眠结构,呼吸,呻吟,并对唤醒事件进行了分析。通过锥形束计算机断层扫描和侧头测量评估三维(3D)和2D颅面硬组织和上气道结构。通过K-均值聚类分析鉴定了疾病的表型,和组间比较进行了评估。
■确定了两个不同的疾病簇:簇1(n=17)的特征是男性更多(71%),呻吟事件的平均持续时间较长(18.5±4.8和12.8±5.7s,p=0.005),和较宽的上呼吸道(体积41,386±10,543和26,661±6700mm3,p<0.001);第2组(n=49)的特征是女性更多(73%),较高的呼吸紊乱指数(RDI)(中位数1.0[0.3,2.0]和5.2[1.2,13.3]/h,p=0.009),更多呼吸努力相关唤醒(RERA)(1[1,109]和32[13,57)],p=0.005),较小的上呼吸道(喉部横截面积512±87和339±84mm2,p<0.001)和更好的治疗反应(41.2%和82.6%,p=0.004)。
■在患有关节炎的患者中发现了两种不同的表型,原发性传染病,和与上呼吸道阻塞相关的颈椎病,提示呼吸事件和上呼吸道结构可能与疾病的病因有关,对其治疗有影响。
UNASSIGNED: Catathrenia is a rare sleeping disorder characterized by repetitive nocturnal groaning during prolonged expirations. Patients with catathrenia had heterogeneous polysomnographic, comorbidity, craniofacial characteristics, and responses to treatment. Identifying phenotypes of catathrenia might benefit the exploration of etiology and personalized therapy.
UNASSIGNED: Sixty-six patients diagnosed with catathrenia by full-night audio/video polysomnography seeking treatment with mandibular advancement devices (MAD) or continuous positive airway pressure (CPAP) were included in the cohort. Polysomnographic characteristics including sleep architecture, respiratory, groaning, and arousal events were analyzed. Three-dimensional (3D) and 2D craniofacial hard tissue and upper airway structures were evaluated with cone-beam computed tomography and lateral cephalometry. Phenotypes of catathrenia were identified by K-mean cluster analysis, and inter-group comparisons were assessed.
UNASSIGNED: Two distinct clusters of catathrenia were identified: cluster 1 (n=17) was characterized to have more males (71%), a longer average duration of groaning events (18.5±4.8 and 12.8±5.7s, p=0.005), and broader upper airway (volume 41,386±10,543 and 26,661±6700 mm3, p<0.001); cluster 2 (n=49) was characterized to have more females (73%), higher respiratory disturbance index (RDI) (median 1.0 [0.3, 2.0] and 5.2 [1.2, 13.3]/h, p=0.009), more respiratory effort-related arousals (RERA)(1 [1, 109] and 32 [13, 57)], p=0.005), smaller upper airway (cross-sectional area of velopharynx 512±87 and 339±84 mm2, p<0.001) and better response to treatment (41.2% and 82.6%, p=0.004).
UNASSIGNED: Two distinct phenotypes were identified in patients with catathrenia, primary catathrenia, and catathrenia associated with upper airway obstruction, suggesting respiratory events and upper airway structures might be related to the etiology of catathrenia, with implications for its treatment.