阻塞性睡眠呼吸暂停与失眠症状并发,客观短睡眠时间与发生性高血压有关
Nikolaos Athanasiou1, Slobodanka Pejovic1, Alexandros N Vgontzas2
1Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
概括
同病性失眠和阻塞性睡眠呼吸暂停 (COMISA),睡眠时间短,显著增加高血压的风险. 这凸显了评估睡眠时间对于准确的COMISA诊断和管理的重要性.
科学领域:
- 睡眠医学 睡眠医学
- 心血管健康 心血管健康
- 流行病学 流行病学
背景情况:
- 同病性失眠和阻塞性睡眠呼吸暂停 (COMISA) 呈现的心血管风险高于单独的任何条件.
- 与睡眠时间短暂的失眠 (ISSD) 相关的COMISA的特定表型需要进一步研究其对高血压的影响.
- 了解这些关联对于公共卫生和临床实践至关重要.
研究的目的:
- 调查COMISA,特别是ISSD表型与发生高血压的风险之间的关联.
- 在一般人口样本中分析与不同睡眠表型相关的高血压风险.
- 确定客观睡眠时间是否是COMISA相关高血压风险的关键因素.
主要方法:
- 一项对来自宾夕法尼亚州立大学成年人群的1395名参与者的纵向研究,其中786名参与者在基线没有高血压.
- 高血压是由高血压的自我报告治疗来定义的.
- 失眠症状,阻塞性睡眠呼吸暂停 (OSA) (呼吸暂停/呼吸暂停指数≥5/h) 和客观的短睡眠时间 (<6小时) 通过多睡眠和问卷进行了评估.
主要成果:
- 与睡眠良好者相比,具有ISSD表型的COMISA表现出发生高血压的最高风险 (OR=4.25,95%CI=1.52-11.90).
- 阻塞性睡眠呼吸暂停单独 (OR=3.31,95% CI=1.85-5.92) 和单独的ISSD (OR=2.27,95% CI=1.29-4) 也显示出与发生高血压的显著关联.
- 没有ISSD表型的COMISA与高血压风险增加没有显著关联.
结论:
- 高血压发展中的COMISA的附加心血管风险主要是由ISSD表型驱动的,它代表了最严重的失眠表现.
- 目标睡眠时间是准确诊断和COMISA患者风险分层的关键因素.
- 将客观睡眠时间与呼吸暂停/呼吸暂停和氧气和指数相结合,可以改善COMISA的诊断和治疗策略.
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