코골기 환자의 임상증상을 통한 수면 다원검사의 의뢰조건

Abstract

Most of patients with snoring have underlying obstructive sleep apnea. Operations for snoring through uvulopalatopharyngoplasty (UPPP) or laser resection of palatopharynx (LRPP) are known to be effective in treatment of snoring but less in obstructive sleep apnea. Therefore polysomnography (PSG) should be recommended in order to evaluate sleep apnea in patient with snoring. However, it is not easy to recommend PSG to all patients with snoring in practice. We performed this study to find the criteria of referral for polysomnography before operation of snoring. 140 patients with snoring and sleep apnea syndrome were studied by the PSG. Sleep apnea questionnaire, Zung's scale for depression, Stanford Sleepiness Scale (SSS), insomnia scale and neuropsychological test were administered. And also, blood pressure, height, weight and neck circumference were measured and some history was taken. Correlations between respiratory disturbance index (RDI) and various parameters mentioned above and discriminant coefficients of the parameters to RDI were computed. Using six parameter(i.e. neck circumference, systolic blood pressure before sleep, degree of alcohol drinking, frequency of breath-holding during sleep, degree of dry mouth during sleep, sleep apnea score), the patients with RDI above 20 could be discriminated in 92.8% sensitivity. In case of more than two among six parameters (neck circumference of above 40cm, systolic blood pressure of above 125mmHg, frequent alcohol drinking, frequent breath-holding during sleep, frequent dry mouth during sleep, sleep apnea score of above 35), same patients could be discriminated in 87.6% sensitivity. In case of more than one among four parameters(neck circumference of above 40cm, systolic blood pressure of above 125mmHg, frequent alcohol drinking, body weight of above 80kg), discrimination sensitivity was 83.5%. In conclusion, the patients suspicious of RDI above 20 using above parameters should be refered for PSG, because whose sleep apnea is not easy to be cured only by snoring operation.