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睡眠呼吸暂停生理负担和心血管发病率和死亡率
Gonzalo Labarca1, Daniel Vena1, Wen-Hsin Hu1
1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
概括
阻塞性睡眠呼吸暂停的低氧和呼吸负担预测心血管疾病和死亡率. 呼吸系统负担解释了大部分低氧负担,突出了其在睡眠呼吸暂停风险中的重要性.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 涉及反复减少呼吸,导致氧气脱和唤醒.
- 不同OSA负担对心血管疾病 (CVD) 风险的影响需要进一步调查.
研究的目的:
- 检查低氧负担与发生心血管疾病的关联,并将其与通风和兴奋负担进行比较.
- 为了确定呼吸器负担,内脏肥胖和肺功能如何影响低氧负担.
主要方法:
- 在MESA和MrOS研究中,从多睡眠图表中量化了缺氧,呼吸和兴奋负担.
- 通风负荷是由通风信号的面积定义的,激发负荷是由累积的激发持续时间定义的.
- 计算了发生心血管疾病和死亡率的调整危险比率.
主要成果:
- 缺氧和呼吸系统负担都与发生心血管疾病和死亡率有显著联系.
- 兴奋负担没有显示出与心血管疾病或死亡率的显著关联.
- 呼吸机负担占低氧负担变化的78%.
结论:
- 在基于人口的研究中,缺氧和呼吸系统负担是心血管疾病发病率和死亡率的重要预测因素.
- 缺氧负担主要是由OSA的呼吸器负担驱动的,而不仅仅是由于脱的倾向.
- 这些发现强调了解决OSA管理中的呼吸系统缺陷的重要性.
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