Nicotine, alcohol, and caffeine use among individuals with untreated obstructive sleep apnea.
Nicotine, alcohol, and caffeine use among individuals with untreated obstructive sleep apnea.
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未经治疗的阻塞性睡眠呼吸暂停患者使用尼古丁、酒精和咖啡因的情况。
DOI：
10.1007/s11325-023-02830-3
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Zinchuk,Andrey
中科院分区：
文献类型：
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作者：
Baldassarri,StephenR;Chu,Jen-Hwa;Deng,Annan;Xu,Zhichao;Blohowiak,ReaganF;Byrne,Sean;Kushida,Clete;Yaggi,HKlar;Zinchuk,Andrey
精神活性物质的使用(即尼古丁、酒精和咖啡因)对健康人的睡眠结构有实质性的影响，但它们对阻塞性睡眠呼吸暂停(OSA)患者的影响尚未得到很好的描述。我们的目的是描述精神活性物质的使用与未经治疗的阻塞性睡眠呼吸暂停患者的睡眠特征和日间症状之间的关系。方法我们对呼吸暂停正压长期疗效研究(APPLES)进行了二次横断面分析。暴露包括未经治疗的阻塞性睡眠呼吸暂停患者目前吸烟、酒精和咖啡因的使用。结果领域包括主观和客观睡眠特征、日间症状和合并症。结果在919名未经治疗的阻塞性睡眠呼吸暂停综合征患者中，116人(12.6%)目前吸烟，585人(63.7%)中度或重度饮酒，769人(83.7%)中度或重度咖啡因使用者。参与者的平均年龄为52.2±11.9岁，其中65.2%为男性，BMI中位数为30.6(IQR：27.2，35.9，kg/m2)。与非吸烟者相比，当前吸烟者的睡眠时间(0.3h)更短，睡眠潜伏期(5min)更长( <； 0.05)。重度或中度饮酒的人表现出更多的快速眼动睡眠(分别占总睡眠时间的2.5%和5%)，中度摄入咖啡因的人也是如此(2%，p值 <； 005)。吸烟者加咖啡因组与不吸烟者相比，睡眠时间较短(p值 <； 0.05)，患慢性疼痛的风险较高[优势比(95%CI) = 4.83(1.5 7，14.9)。结论未经治疗的阻塞性睡眠呼吸暂停患者使用精神活性物质与睡眠特征及临床相关。进一步研究各种物质对这一人群的影响可能为更全面地了解疾病机制和提高阻塞性睡眠呼吸暂停综合征的治疗效果提供机会。
BackgroundPsychoactive substance use (i.e., nicotine, alcohol, and caffeine) has substantial effects on sleep architecture in healthy individuals, but their effects in those with obstructive sleep apnea (OSA) have not been well described. We aimed to describe the association between psychoactive substance use and sleep characteristics and daytime symptoms in individuals with untreated OSA.MethodsWe performed a secondary, cross-sectional analysis of The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Exposures included current smoking, alcohol and caffeine use in individuals with untreated OSA. Outcome domains included subjective and objective sleep characteristics, daytime symptoms, and comorbid conditions. Linear or logistic regression assessed the association between substance use and each domain (e.g., self-reported sleep duration, total polysomnographic sleep time, sleepiness, and anxiety).ResultsOf the 919 individuals with untreated OSA, 116 (12.6%) were current cigarette smokers, 585 (63.7%) were moderate or heavy alcohol users, and 769 (83.7%) were moderate or heavy caffeine users. Participants were on average 52.2±11.9 years old, 65.2% were male with a median BMI of 30.6 (IQR: 27.2, 35.9, kg/m2). Current smokers exhibited lower sleep duration (0.3 h), longer sleep latency (5 min) compared with non-smokers (allp-values < 0.05). People with heavy or moderate alcohol use exhibited more REM sleep (2.5 and 5% of total sleep time respectively), as did those with moderate caffeine use (2%,p-values < 0.05). The combined smoker plus caffeine group exhibited shorter sleep duration (0.4 h, p-value < 0.05) and higher risk for chronic pain [Odds Ratio (95%CI) = 4.83 (1.57, 14.9) compared with non-users.ConclusionsPsychoactive substance use is associated with sleep characteristics and clinically relevant correlates in people with untreated OSA. Further investigation into the effects that various substances have on this population may present opportunities to understand disease mechanisms more fully and increase the effectiveness of treatment in OSA.