阻塞性睡眠呼吸暂停是一种普遍的睡眠呼吸紊乱病症,其特征在于睡眠期间呼吸的重复减少。目前阻塞性睡眠呼吸暂停的护理标准是持续的正气压装置,经常患有低耐受性由于有限的坚持。利用嗅觉感知的独特神经回路及其在睡眠期间保留的功能,我们进行了一项试点研究来测试瞬态,基于呼吸的嗅觉刺激作为阻塞性睡眠呼吸暂停标志物的治疗。32例阻塞性睡眠呼吸暂停患者(呼吸暂停低通气指数≥每小时15次事件)接受了两次多导睡眠监测,“气味”和“控制”,以随机顺序。在“气味”的夜晚,患者接受了通过计算机控制的商用嗅觉计(Scentific)进行的短暂的基于呼吸的嗅觉刺激.嗅觉计,配备了无线监控,分析呼吸模式,并在检测到呼吸事件时呈现气味。“控制”之夜没有气味。在排除之后,17名患者进入分析(4名女性,47.4(10.5)年,体重指数:29.4(6.3)kgm-2)。我们观察到睡眠期间的嗅觉刺激降低了呼吸暂停低通气指数(“气味”:17.2(20.9),“控制”:28.2(18.6),z=-3.337,p=0.000846,BF10[贝叶斯因子10]=57.9),反映事件数量平均减少31.3%。相关地,刺激使氧饱和度降低26.9%(“气味”:12.5(15.8),“控制”:25.7(25.9),z=-3.337,p=0.000846,BF10=9.522)。这种影响与基线阻塞性睡眠呼吸暂停标志物的严重程度无关(ρ=-0.042,p=0.87)。嗅觉刺激不会从睡眠中引起或影响睡眠结构,以每个睡眠阶段的时间测量(F1,16=0.088,p=0.77)。总之,睡眠期间的嗅觉刺激可有效降低阻塞性睡眠呼吸暂停标志物的严重程度,而不会引起唤醒,并可能为阻塞性睡眠呼吸暂停提供一种新的治疗方法,促使继续研究。
Obstructive sleep apnea is a prevalent sleep-disordered breathing condition characterized by repetitive reduction in breathing during sleep. The current care standard for obstructive sleep apnea is continuous positive air pressure devices, often suffering from low tolerance due to limited adherence. Capitalizing on the unique neurocircuitry of olfactory perception and its retained function during sleep, we conducted a pilot study to test transient, respiration-based olfactory stimulation as a treatment for obstructive sleep apnea markers. Thirty-two patients with obstructive sleep apnea (apnea-hypopnea index ≥ 15 events per hr) underwent two polysomnography sessions, \"
Odour\" and \"Control\", in random order. In \"
Odour\" nights, patients were presented with transient respiratory-based olfactory stimulation delivered via a computer-controlled commercial olfactometer (Scentific). The olfactometer, equipped with a wireless monitoring, analysed respiratory patterns and presented
odour upon detection of respiratory events. No odours were presented in \"Control\" nights. Following exclusions, 17 patients entered the analysis (four women, 47.4 (10.5) years, body mass index: 29.4 (6.3) kg m-2). We observed that olfactory stimulation during sleep reduced the apnea-hypopnea index (\"
Odour\": 17.2 (20.9), \"Control\": 28.2 (18.6), z = -3.337, p = 0.000846, BF10 [Bayesian Factor 10]= 57.9), reflecting an average decrease of 31.3% in the number of events. Relatedly, stimulation reduced the oxygen desaturation index by 26.9% (\"
Odour\": 12.5 (15.8), \"Control\": 25.7 (25.9), z = -3.337, p = 0.000846, BF10 = 9.522). This effect was not linked to the severity of baseline obstructive sleep apnea markers (ρ = -0.042, p = 0.87). Olfactory stimulation did not arouse from sleep or affect sleep structure, measured as time per sleep stage (F1,16 = 0.088, p = 0.77). In conclusion, olfactory stimulation during sleep was effective in reducing the severity of obstructive sleep apnea markers without inducing arousals, and may provide a novel treatment for obstructive sleep apnea, prompting continued research.