CAJ | 학술논문

目的探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对飞行员白天过度嗜睡(excessive daytime sleepiness,EDS)、情绪状态和主观生活质量(subjective quality of life,QOF)的影响.方法对经多导睡眠仪(polysomnography,PSG)监测诊断的54例OSAS飞行员和30例正常飞行员做人体测量、记录Epworth嗜睡量表评分(Epworth sleepiness scale,ESS)、睡眠呼吸暂停生活质量指数(calgary sleep apnea quality of life index,SAQLI)和Zung抑郁自评量表(Zung self-rated depression scale,SDS),将所获资料进行描述和均数比较.结果 OSAS飞行员中76.6％超重,20.3％肥胖；28.1％存有白天嗜睡,对日常工作及生活有明显影响；41.7％的患者抑郁,抑郁症状与白天嗜睡及疲劳有明显关系.比较正常飞行员和不同程度OSAS飞行员的体质指数、颈围、呼吸暂停低通气指数(sleep apnea hypopnea index,AHI)、ESS、SAQLI和SDS评分,差异均有统计学意义(F=6.28～270.29,P＜0.01)；进一步分析发现,SAQLI和AHI在正常和轻度患者之间差异有统计学意义(P＜0.01),ESS在正常和轻度患者之间差异无统计学意义(P＞0.05),而在正常和中重度患者之间差异有统计学意义(P＜0.01).本研究12例OSAS歼击机飞行员中9例轻度,3例中度,经减轻体重,复测PSG参数和ESS评分正常,均飞行合格；42例OSAS运输机飞行员中13例轻度,飞行合格；15例中度,经减轻体重,PSG参数和ESS评分正常,飞行合格；14例重度,其中8例经减轻体重症状好转飞行合格,6例尚在治疗中.结论 OSAS飞行员常伴有白天过度嗜睡和抑郁情绪,其主观生活质量较正常者明显下降.中度及重度OSAS飞行员应进行干预治疗.
목적 탐토조새성수면호흡잠정종합정(obstructive sleep apnea syndrome,OSAS)대비행원백천과도기수(excessive daytime sleepiness,EDS)、정서상태화주관생활질량(subjective quality of life,QOF)적영향.방법 대경다도수면의(polysomnography,PSG)감측진단적54례OSAS비행원화30례정상비행원주인체측량、기록Epworth기수량표평분(Epworth sleepiness scale,ESS)、수면호흡잠정생활질량지수(calgary sleep apnea quality of life index,SAQLI)화Zung억욱자평량표(Zung self-rated depression scale,SDS),장소획자료진행묘술화균수비교.결과 OSAS비행원중76.6％초중,20.3％비반；28.1％존유백천기수,대일상공작급생활유명현영향；41.7％적환자억욱,억욱증상여백천기수급피로유명현관계.비교정상비행원화불동정도OSAS비행원적체질지수、경위、호흡잠정저통기지수(sleep apnea hypopnea index,AHI)、ESS、SAQLI화SDS평분,차이균유통계학의의(F=6.28～270.29,P＜0.01)；진일보분석발현,SAQLI화AHI재정상화경도환자지간차이유통계학의의(P＜0.01),ESS재정상화경도환자지간차이무통계학의의(P＞0.05),이재정상화중중도환자지간차이유통계학의의(P＜0.01).본연구12례OSAS섬격궤비행원중9례경도,3례중도,경감경체중,복측PSG삼수화ESS평분정상,균비행합격；42례OSAS운수궤비행원중13례경도,비행합격；15례중도,경감경체중,PSG삼수화ESS평분정상,비행합격；14례중도,기중8례경감경체중증상호전비행합격,6례상재치료중.결론 OSAS비행원상반유백천과도기수화억욱정서,기주관생활질량교정상자명현하강.중도급중도OSAS비행원응진행간예치료.
Objective To suggest intervention by investigating the effects of obstructive sleep apnea syndrome(OSAS) on pilot's sleepiness,mood and subjective quality of life.Methods Fiftyfour pilots,who were diagnosed as OSAS by polysomnography (PSG),and 30 normal flying personnel were measured by anthropometry,Epworth Sleepiness Scale(ESS),Calgary Sleep Apnea Quality of Life Index(SAQLI) and Zung self-rated depression scale (SDS).Data were processed by descriptive review and mean valve comparison.Results Among OSAS pilots,76.6％ of them were oveweighed,while 20.3％ were obesity and 28.1％ showed excessive daytime sleepiness.Those significantly affected their work and life.41.7％ OSAS pilots expressed depression or depression symptom,which indicated close correlation to excessive daytime sleepiness and fatigue.Comparisons of body mass index (BMI),neck circumference,sleep apnea/hypopnea index (AHI),the longest time of breathing disorder (BDLon),ESS and SAQLI showed significant difference between OSAS and normal pilots (F=6.28-270.29,P＜0.01).Further analysis showed statistical difference between the normal and mild OSAS pilots on SAQLI and AHI (P＜0.01).Even ESS had no significant difference with mild OSAS pilots ( P＞ 0.05 ) but with the moderate ( P ＜ 0.01 ).Twelve OSAS fighter pilots,including 9 mild and 3 moderate cases,got normal results in PSG and ESS test when they reduced weight,and then were qualified for flying.Among 42 OSAS transporter pilots,13 mild cases were directly qualified while 15 moderate and 8 severe cases returned to the normal in PSG and ESS test by weight reduction and they passed the assessment for flying.Another 6 severe cases were in treatment.Conclusions OSAS pilots are usually with the symptoms of excessive daytime sleepiness and depression mood.Their subjective quality of life is significantly degraded as compared with the normal.It is suggested that necessary intervention should be considered especially to the moderate and severe OSAS pilots.