摘要
目的基于对心率变异性(heart rate variability,HRV)相关指标的分析,探讨常驻高原飞行人员阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)风险与HRV的相关性,评估睡眠呼吸障碍对飞行人员日间自主神经功能的影响。方法抽取常驻高原某部军事飞行人员47名,进行睡眠问卷调查,使用头戴式HRV监测设备采集短时HRV,使用STOP-BANG量表(STOP-BANG Questionnaire,SBQ)和Epworth嗜睡量表(Epworth Sleepiness Scale,ESS)进行OSAS风险评估。根据量表评估结果将飞行人员分为OSAS风险组和正常组,分析2组睡眠问卷结果、HRV指标差异及HRV与SBQ、ESS评分的相关性。结果47名飞行人员中,风险组20名,正常组27名,2组年龄、BMI、飞行时间、常驻高原时间和总睡眠时间差异均无统计学意义(P均>0.05);风险组注意力/记忆力下降发生占比高于正常组(χ^(2)=4.335,P=0.037);风险组高频功率(high frequency,HF)高于正常组(t=2.933,P=0.007),其余HRV指标间差异无统计学意义(P均>0.05);ESS评分和HF呈中度正相关(rs=0.402,P=0.005),SBQ评分和HF、RR间期>50 ms的心跳次数百分比呈低正相关(rs=0.394、0.299,P=0.006、0.041)。结论OSAS风险较高的常驻高原飞行人员更易出现睡眠不足相关日间症状,尤其是注意力/记忆力下降;这类飞行人员存在自主神经功能紊乱,以副交感神经兴奋性增高为主,且白天嗜睡程度越高的飞行人员,副交感神经张力越高。提示在应对高原飞行人员睡眠障碍问题时,应同时关注自主神经功能异常和相关疾病。
Objective To explore the correlations between the risk of obstructive sleep apnea syndrome(OSAS)and heart rate variability(HRV)based on HRV,and to study the effect of sleep-disordered breathing on daytime autonomic nervous function in high-altitude military flying personnel.Methods A total of 47 military flying personnel stationed at high altitudes were selected as the subjects.A sleep questionnaire survey was conducted,data on short-term HRV was collected by a head-mounted HRV monitoring device and the risk of OSAS was assessed using the STOP-BANG scale and Epworth scale.Participants were divided into the risk group and normal group according to the results of evaluation of scales.Thefindings of the survey,the difference in HRV indexes and correlations between HRV and the scores of STOP-BANG scale and Epworth scale were analyzed across the 2 groups.Results Out of the 47flying personnel,20 were in the risk group and the rest were in the normal group.There were no significant differences in age,BMI,durations offlight,length of long-term stay on the plateau and total sleep time(all P>0.05)between the 2 groups.The incidence of attention/memory decline in the risk group was higher than that in the normal group(χ^(2)=4.335,P=0.037),so was the high frequency power(HF)(t=2.933,P=0.007).There was no significant difference between other HRV indexes(all P>0.05).The Epworth scale score had a moderate positive correlation with HF(rs=0.402,P=0.005),while the STOP-BANG scale had a low positive correlation with HF and PNN50(%)(rs=0.394,0.299,P=0.006,0.041).Conclusion Flying personnel at high risk of OSAS are more vulnerable to daytime symptoms related to sleep deficiency,especially decreased attention/memory.In addition,they are likely to develop autonomic nervous dysfunction,such as increased parasympathetic excitability.The more sleepy during the day,the higher the parasympathetic tension.It is recommended that autonomic nervous dysfunction be taken into consideration in case of sleep disorders amongflying personnel at high altitudes.
作者
周潇潇
谢俊豪
刘雅贞
陈小洁
钱嘉诚
张泽翰
徐先荣
刘娟
ZHOU Xiaoxiao;XIE Junhao;LIU Yazhen;CHEN Xiaojie;QIAN Jiacheng;ZHANG Zehan;XU Xianrong;LIU Juan(Department of Special Medical Service,Army Medical Center,Army Medical University,Chongqing 400042;Unit 77126 of PLA;Unit 32166 of PLA;Clinical Medicine Department,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)
出处
《空军航空医学》
2025年第3期234-238,共5页
AVIATION MEDICINE OF AIR FORCE
