▎药明康德团队
前段时间有一条新闻,说印度尼西亚某航空公司一架载着100多人的客机上,机长和副驾驶员同时睡着了大约28分钟,导致飞机偏离了预定航线。
报告显示,在飞行过程中,副驾因前一天休息不足,向主驾机长请求休息。主驾同意后,副驾在驾驶舱内睡了约30分钟。
而在返程航班中,主驾睡着了,副驾在执飞时也不慎入睡,直到主驾醒来并发现问题才紧急纠正,最终将飞机降落在雅加达。
还好没有人因此受伤,飞机也没有损坏。不过印尼国家运输安全委员会仍然把这个事故定性为“严重”事件,航空公司在事发后第二天,就对32岁的机长和28岁的副驾驶员进行了停飞及停职处理。
他们是如此年轻,却如此缺觉。
很多人会想,飞行员按道理应该严格保证睡眠时长,为什么还会缺觉呢?
可每天睡8小时,不等于拥有8小时的优质睡眠。
相反,如果你每天醒来都感觉没休息好,说明睡眠质量是比较差的。
图片来源:123RF
影响睡眠质量的因素有很多,比如:睡眠习惯差、睡眠环境不好(温湿度、噪音、光线),鼻中隔弯曲、鼻甲肥大、肥胖、心血管疾病、抑郁症、长期的思想矛盾、精神负担过重以及病后体弱等。
还有一个看似“稀松平常”的现象,却对睡眠质量影响很大,那就是经常打鼾(鼾症)、鼾声大而且不规律——这是阻塞性睡眠呼吸暂停(OSA)的典型症状。
这个病不仅伤身体,还可能要了别人的命
阻塞性睡眠呼吸暂停是一种常见的睡眠呼吸疾病,中国约有1.76亿患者。
在成人中的诊断标准是:每晚7小时睡眠中呼吸暂停及低通气反复发作30次以上,或呼吸暂停低通气指数≥5次/小时。
图片来源:123RF
这个病不只会导致打鼾,还会严重影响夜间睡眠质量,患者晚上睡着后会有窒息感或会被憋醒,白天会困倦、嗜睡、难以集中精力、记忆力下降,甚至认知功能下降、行为异常。
此外,长期患病还会累及心脏、大脑、血管,导致冠心病、心衰、中风、糖尿病,甚至增加死亡风险。
而一项超过5000人的研究显示,在开始没有已知心血管疾病的参与者里,被确诊为阻塞性睡眠呼吸暂停的人,预计在7.5年内心血管疾病发病率会增加,而且死亡风险增加了2.4倍。
在高血压、冠心病、心力衰竭和心房颤动等心血管疾病的患者中,阻塞性睡眠呼吸暂停的患病率是40%-80%;在2型糖尿病住院患者中,患病率约为60%。
而对于开头提到的职业司机、飞行员这类人群,这个病的后果尤其严重。
毕竟,没睡好对于普通人只是影响个人生活和健康,而对于这些人,就是拿自己和别人的生命在冒险。
不信,请看大数据——
中国一项调查研究显示,广州市货运司机鼾症患病率为37.3%,阻塞性睡眠呼吸暂停的患病率为12.5%。
其他国家还有数据显示,在职业卡车司机中,阻塞性睡眠呼吸暂停的患病率为28%-78%,明显高于普通人群。
图片来源:123RF
研究显示,患有阻塞性睡眠呼吸暂停而未经治疗的驾驶员,发生的交通事故是不患这个病的驾驶员的3.43倍。
而如果针对制定全面的筛查、诊治方案,可将交通事故减少73%。
除了职业司机、飞行员,还有一些特殊职业对警觉性和安全性要求很高,如消防员、从事危险工作(如高空作业、伐木等)的人群等,都有必要进行筛查。
你是阻塞性睡眠呼吸暂停的高危人群吗?
关于高危人群的特征,2022年发布的中国《成人阻塞性睡眠呼吸暂停高危人群筛查与管理专家共识》都总结在这个表里了:
图片来源:参考资料[2]
大家都知道,肥胖的人打鼾比较厉害,而他们也是这个病的高危人群。
60%-90%的阻塞性睡眠呼吸暂停患者伴有肥胖;
肥胖人群中,这个病的患病率约为40%;
在接受减肥手术的人群(一般是中重度肥胖患者)中,患病率甚至高达80.5%。
值得注意的是,在外科手术中,阻塞性睡眠呼吸暂停患者发生并发症的风险也更高,尤其是减重手术。医护人员会对高危人群进行术前筛查,以更大限度地降低手术、麻醉剂和术后用药带来的风险。
其他高危因素还有:男性、绝经后女性、年龄的增长、上气道及颌面结构异常、不良生活方式(长期大量饮酒或吸烟)、遗传因素(有家族史)和使用镇静安眠类药物等。
怎么知道自己有没有患病呢?
目前的筛查工具以睡眠量表和客观睡眠监测设备为主。
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#7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: #000;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);--weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media screen and (min-width:1024px){body:not(.pages_skin_pc) .wx-root[data-weui-theme=dark],body:not(.pages_skin_pc) body[data-weui-theme=dark]{--appmsgExtra-BG: #121212}}@media screen and (min-width:1024px){body:not(.pages_skin_pc)body:not(.pages_skin_pc){background:var(--weui-BG-2)}}@media screen and (min-width:1024px) and (prefers-color-scheme:dark){body:not(.pages_skin_pc) 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rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media screen and (min-width:1024px) and (prefers-color-scheme:dark){body:not(.pages_skin_pc) .wx-root:not([data-weui-theme=light]),body:not(.pages_skin_pc) body:not([data-weui-theme=light]){--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: #404040;--weui-BG-5: #2c2c2c;--weui-FG-0: rgba(255, 255, 255, .8);--weui-FG-HALF: rgba(255, 255, 255, .6);--weui-FG-1: rgba(255, 255, 255, .5);--weui-FG-2: rgba(255, 255, 255, .3);--weui-FG-3: rgba(255, 255, 255, .1);--weui-FG-4: rgba(255, 255, 255, .15);--weui-FG-5: rgba(255, 255, 255, .1);--weui-RED: #fa5151;--weui-ORANGERED: 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