• J Zhang, Y Peng, and W Fu.
• Union Hospital of Tongji Medical College, Huazhong Science and Technology University, Wuhan 430022, China.
• Zhonghua Jie He He Hu Xi Za Zhi. 2001 Mar 1; 24 (3): 155-7.

ObjectiveTo explore the stimuli triggering respiratory arousal.MethodsTwenty-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.ResultsPatients 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).ConclusionArousals from sleep in patients with obstructive sleep disordered breathing might be mainly caused by inspiratory flow limitation rather than by episodic apnea or desaturation.

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