摘要目的探讨导致睡眠呼吸障碍患者睡眠中频繁发生觉醒的原因。方法对因有白天过度困倦而就诊的25例患者作全晚多导睡眠图(PSG)检查和呼吸模式分析，并与 7名健康正常人对照。按国际标准人工判断觉醒。结果上气道阻力综合征(UARS)组：10例，呼吸暂停／低呼吸指数(AHI)（2.5±1.4）次/h，动脉血氧饱和度(SaO2)<90%累计时间% (SLT90%) （0.1±0.1）%，觉醒指数(ArI)（30±16）次/h；阻塞性睡眠呼吸暂停综合征(OSAS)组：15例，AHI（32.8±19.1）次/h，SLT90%（11.3±16.5）%，ArI（35±17）次/h；正常人组：7名，AHI（5.9±4.4）次/h，SLT90%（0.2±0.4）%，ArI（13±5）次/h。OSAS和UARS组的ArI无统计学差异(H=0.49, P=0.48)，均高于正常对照组的ArI (H分别为7.36和5.22，P值分别为0.001和0.02)，但UARS组AHI、SLT90%明显低于OSAS组(H>5.00, P<0.05)，与正常组相近(P>0.05)。结论睡眠时上气道吸气性阻力增高，是导致睡眠频繁觉醒的主要原因。

abstractsObjective　To explore the stimuli triggering respiratory arousal. Methods　Twenty-five patients with excessive daytime sleepiness (EDS) were monitored by nocturnal polysomonography (PSG) and respiratory inductive plethysmography. Patients with obstructive apnea/hypopnea index (AHI) ≥5/h were diagnosed as obstructive sleep apnea syndrome (OSAS). Patients with Epworth Sleepiness Score ≥12, frequent inspiratory flow limitation related arousal during sleep and AHI < 5/h were diagnosed as upper airway resistance syndrome (UARS). Seven normal subjects were recruited as controls. Results　Patients with OSAS：AHI(32.8±19.1)/h, percentage of time spend when oxygen saturation lower than 90% (SLT90%) (11.3±16.5)%, arousal index (ArI) (35±17)/h, n=15. Patients with UARS：AHI(2.5±1.4)/h, SLT90% (0.1±0.1)%, ArI(30±16)/h, n=10. Normal subjects：AHI (5.9±4.4)/h, SLT90%(0.2±0.4)%, ArI(13±5)/h, n=7. Though the levels of AHI and SLT90% in patients with UARS were similar to those in normal subjects(H=2.92, P=0.87 or H=0.086, P=0.77), much lower than those in OSAS patients(H=12.3, P=0.000 5 and H=6.64, P=0.01), ArI in UARS was just as high as that in OSAS (H=0.49, P=0.48).Conclusion　Arousals from sleep in patients with obstructive sleep disordered breathing might be mainly caused by inspiratory flow limitation rather than by episodic apnea or desaturation.