Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: a longitudinal analysis of the Wisconsin Sleep Cohort.
Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: a longitudinal analysis of the Wisconsin Sleep Cohort.
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DOI：
10.1136/thoraxjnl-2015-207231
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发表时间：
2015-11
期刊：
影响因子：
10
通讯作者：
Peppard PE
中科院分区：
文献类型：
--
作者：
Mokhlesi B;Hagen EW;Finn LA;Hla KM;Carter JR;Peppard PE
夜间血压（BP）不下降与靶器官损害和心血管疾病有关。阻塞性睡眠呼吸暂停（OSA）与非浸渍事件有关。然而，在快速眼动（REM）睡眠期间呼吸紊乱与发生非浸渍风险之间的关系尚未得到研究。本研究调查了快速眼动睡眠期阻塞性睡眠呼吸暂停是否与非浸渍事件有关。我们的样本包括269名参加威斯康星州睡眠队列研究的成年人，他们在平均6.6年的随访中完成了两项或更多的24小时动态血压研究。在排除基线时血压普遍非下降或使用抗高血压药物的参与者后，分别有199和215名参与者可用于收缩压和舒张压非下降的纵向分析。REM和非REM睡眠中的OSA由实验室多导睡眠图基线的呼吸暂停低通气指数（AHI）定义。收缩压和舒张压非下降定义为收缩压和舒张压睡眠/觉醒比值> 0.9。改良泊松回归模型估计REM AHI和事件nondipping之间的关系的相对风险，调整非REM AHI和其他协变量。在REM睡眠中，随着OSA严重程度的增加，收缩压和舒张压非下降的风险增加（收缩压和舒张压非下降的p趋势=0.021和0.024）。相对于REM AHI<1起事件/hr的患者，REM AHI≥15的患者发生收缩期非倾斜（2.84，95%CI 1.10-7.29）和舒张期非倾斜（4.27，95%CI 1.20-15.13）的相对风险更高。我们的研究结果表明，在一个以人群为基础的样本中，REM OSA与BP的非下降事件独立相关。
Nondipping of nocturnal blood pressure (BP) is associated with target organ damage and cardiovascular disease. Obstructive sleep apnea (OSA) is associated with incident nondipping. However, the relationship between disordered breathing during rapid eye movement (REM) sleep and the risk of developing nondipping has not been examined. This study investigates whether OSA during REM sleep is associated with incident nondipping. Our sample included 269 adults enrolled in the Wisconsin Sleep Cohort Study who completed two or more 24-hour ambulatory BP studies over an average of 6.6 years of follow-up. After excluding participants with prevalent nondipping BP or antihypertensive use at baseline, there were 199 and 215 participants available for longitudinal analysis of systolic and diastolic nondipping, respectively. OSA in REM and non-REM sleep were defined by apnea-hypopnea index (AHI) from baseline in-laboratory polysomnograms. Systolic and diastolic nondipping were defined by systolic and diastolic sleep/wake BP ratios > 0.9. Modified Poisson regression models estimated the relative risks for the relationship between REM AHI and incident nondipping, adjusting for non-REM AHI and other covariates. There was a dose-response greater risk of developing systolic and diastolic non-dipping BP with greater severity of OSA in REM sleep (p-trend=0.021 for systolic and 0.024 for diastolic nondipping). Relative to those with REM AHI<1 event/hr, those with REM AHI≥15 had higher relative risk of incident systolic non-dipping (2.84, 95% CI 1.10-7.29) and incident diastolic non-dipping (4.27, 95% CI 1.20-15.13). Our findings indicate that in a population-based sample, REM OSA is independently associated with incident nondipping of BP.
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影响因子：
16.2
作者：
Grimaldi D;Beccuti G;Touma C;Van Cauter E;Mokhlesi B
通讯作者：
Mokhlesi B
影响因子：
5.6
作者：
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Stubbs, Maryan
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影响因子：
15.9
作者：
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通讯作者：
ABBOUD, FM
影响因子：
158.5
作者：
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