Obstrüktif uyku apne sendrom'lu hastalarda CPAP tedavisinin gündüz uyku hali ve serum substans p düzeyleri üzerine etkisinin araştırılması
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Date
2017
Authors
Güçlü, Özge Aydın
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Publisher
Uludağ Üniversitesi
Abstract
Obstrüktif uyku apnesi sendromu (OUAS), uyku sırasında tekrarlayan üst solunum yolu obstrüksiyonları, intermittan hipoksi ve arousallar ile seyreden bir hastalıktır. Tekrarlayan uyanma, dinlendirici olmayan uyku, yorgunluk, konsantrasyon güçlüğü sık görülen yakınmalardır. Çalışmamızın amacı OUAS hastalarında devamlı pozitif havayolu basıncı (CPAP) tedavisinin gündüz uyku hali ve serum Substans P (SP) düzeyleri üzerine etkisinin araştırılmasıdır. Uludağ Üniversitesi Göğüs Hastalıkları Genel Polikliniği'ne başvuran horlama, tanıklı apne, gündüz aşırı uyku hali semptomları olan, hipertansiyon dışında ciddi medikal rahatsızlığı olmayan 90 hasta çalışmamıza dahil edildi. OUAS tanısını kesinleştirmek için tüm olgulara Uludağ Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Uyku Laboratuarı'nda tekniker gözetimiyle polisomnografi (PSG) yapıldı. Hastalara PSG yapılmadan önce Epworth Uykululuk Ölçeği (ESS), Pittsburg Uyku Kalitesi Ölçeği (PSQI) ve Uykunun Fonksiyonel Sonuçları Ölçeği (FOSQ) anketleri uygulandı. AHİ ≥ 5 olan olgular çalışma grubu (n=19), basit horlama saptanan olgular (AHİ<5) kontrol grubu (n=71) olarak alındı. Çalışmaya katılan hastaların 71'i (%78,9) erkek, 19'u (%21,1) kadın idi. Yaş ortalamaları 45 [20-62] idi. Polisomnografi sonrası alınan kan örneklerinde daha önceki çalışmalarda olduğu gibi OUAS grubunun SP düzeylerinin kontrol grubuna göre istatistiksel anlamlı olarak düşük olduğunu ve SP düzeyinin AHİ ile negatif korele olduğunu saptadık. Ancak olgular ESS skorlarına göre ESS<10 ve ESS≥10 olarak iki grup halinde değerlendirildiğinde gruplar arasında serum SP başlangıç düzeyleri açısından anlamlı fark tespit edilmedi. Başlangıç SP değerleri ile ESS arasında korelasyon saptanmadı. Pozitif hava yolu basıncı tedavisi başlanan olgular 3 ay tedavi aldıktan sonra kullanım süreleri, serum SP değerleri, gündüz aşırı uyku hali, yaşam kalitesi ve uyku kalitesi açısından yapılan anketler ile değerlendirildi. Üç aylık tedavi sonrası olguların 3. ay ve başlangıç SP değerleri karşılaştırıldı. SP düzeylerinin tedavi sonrası anlamlı derecede azalığı tespit edildi. Üç yüz saat ve üzeri kullanım süresi olan tedavi uyumu iyi olarak değerlendirilen olgular ele alındığında bu olguların da 3. ay kontrol SP düzeylerinin başlangıç değerlerine göre belirgin olarak azaldığı saptandı. Kullanım süresine göre yapılan analiz sonuçlarına göre 3. ay ve başlangıç SP değişim yüzdesi ile kullanım süresi arasında korelasyon bulunmadığı tespit edildi.
Obstructive sleep apnea syndrome (OSAS) is a commonly seen disorder characterized by repeated episodes of upper airway obstruction during sleep leading to intermittent hypoxemia or arousal. The aim of our study was the investigation of the effect of continuous positive airway pressure (CPAP) treatment on daytime sleepiness and serum Substance P (SP) levels in OSAS patients. Our study was carried out with 90 patients who were followed at Uludag University Faculty of Medicine Department of Pulmonary Disease. Patients who has symptoms as snoring, witnessed apnea, symptoms of excessive daytime sleepiness and without severe medical condition other than hypertension included the study. To confirm the diagnosis of OSAS, polysomnography (PSG) was performed under the supervision of a sleep technician in Uludag University Faculty of Medicine Department of Pulmonary Disease Sleep Laboratory. The Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Scale (PSQI) and Sleep Functional Results Scale (FOSQ) were administered before the PSG was performed. Subjects with AHI ≥ 5 were considered to have OSAS. Subjects with AHI < 5 were included in the control group. Blood samples were drawn after the sleep study. 71 patients (78.9%) were male and 19 patients (21.1%) were female. Median age of population was 45 [20-62]. Serum substance P levels of the OSAS group were significantly lower than those of the control group. SP levels were negatively correlated with AHI as in previous stuies. However, when the cases were evaluated as ESS <10 and ESS≥10 according to ESS scores, no significant difference was found between the groups in terms of serum SP baseline levels. There was no correlation between initial SP values and ESS. After 3 months of treatment, patients was assessed by questionnaires from the point of view of cases, daytime sleepiness, quality of life and sleep quality and serum SP levels. After 3 months of treatment, 3rd month and initial SP values were compared. SP levels significantly decreased after treatment. When the cases with three hundred hours and over the period of use were taken into account, these cases were also found to be significantly decreased compared to the baseline values of the 3rd month control SP levels. The results of the analysis according to the duration of use showed that there was no correlation between the SP change percentage and duration of use.
Obstructive sleep apnea syndrome (OSAS) is a commonly seen disorder characterized by repeated episodes of upper airway obstruction during sleep leading to intermittent hypoxemia or arousal. The aim of our study was the investigation of the effect of continuous positive airway pressure (CPAP) treatment on daytime sleepiness and serum Substance P (SP) levels in OSAS patients. Our study was carried out with 90 patients who were followed at Uludag University Faculty of Medicine Department of Pulmonary Disease. Patients who has symptoms as snoring, witnessed apnea, symptoms of excessive daytime sleepiness and without severe medical condition other than hypertension included the study. To confirm the diagnosis of OSAS, polysomnography (PSG) was performed under the supervision of a sleep technician in Uludag University Faculty of Medicine Department of Pulmonary Disease Sleep Laboratory. The Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Scale (PSQI) and Sleep Functional Results Scale (FOSQ) were administered before the PSG was performed. Subjects with AHI ≥ 5 were considered to have OSAS. Subjects with AHI < 5 were included in the control group. Blood samples were drawn after the sleep study. 71 patients (78.9%) were male and 19 patients (21.1%) were female. Median age of population was 45 [20-62]. Serum substance P levels of the OSAS group were significantly lower than those of the control group. SP levels were negatively correlated with AHI as in previous stuies. However, when the cases were evaluated as ESS <10 and ESS≥10 according to ESS scores, no significant difference was found between the groups in terms of serum SP baseline levels. There was no correlation between initial SP values and ESS. After 3 months of treatment, patients was assessed by questionnaires from the point of view of cases, daytime sleepiness, quality of life and sleep quality and serum SP levels. After 3 months of treatment, 3rd month and initial SP values were compared. SP levels significantly decreased after treatment. When the cases with three hundred hours and over the period of use were taken into account, these cases were also found to be significantly decreased compared to the baseline values of the 3rd month control SP levels. The results of the analysis according to the duration of use showed that there was no correlation between the SP change percentage and duration of use.
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Keywords
Obstruktif uyku apne sendromu, Substans P, CPAP, Obstructive sleep apnea syndrome, Substance P
Citation
Güçlü, Ö. A. (2017). Obstrüktif uyku apne sendrom'lu hastalarda CPAP tedavisinin gündüz uyku hali ve serum substans p düzeyleri üzerine etkisinin araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.