Sleep fragmentation, awake blood pressure, and sleep-disordered breathing in a population-based study
Sleep fragmentation, awake blood pressure, and sleep-disordered breathing in a population-based study
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DOI：
10.1164/ajrccm.162.6.9904008
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发表时间：
2000-12-01
影响因子：
24.7
通讯作者：
Young, T
中科院分区：
文献类型：
--
作者：
Morrell, MJ;Finn, L;Young, T
从睡眠中唤醒会引起全身血压的短暂升高，这就暗示了重复的唤醒与白天血压的持续升高有关。利用来自威斯康星州睡眠队列研究的数据，一项基于人群的研究，我们测试了睡眠碎片与清醒时血压升高相关的假设。对1,021名参与者（年龄42 ± 8岁; 590名男性）的睡眠、呼吸和坐位血压测量结果进行了分析。睡眠碎片被定义为觉醒和转移到第1阶段睡眠的总次数除以总睡眠时间（睡眠碎片指数：SFI）。为了减少睡眠呼吸障碍的混杂影响，这与白天血压升高和睡眠碎片有关，对呼吸暂停低通气指数（AHI）大于或等于1的所有参与者进行了单独分析。考虑到性别、年龄、体重指数和抗高血压药物使用的影响，在AHI < 1的人群中，SFI与较高水平的清醒收缩压显著相关; SFI增加2个标准差与清醒收缩压升高3.1 mm Hg相关。在AHI 1的参与者中，在控制了AHI的影响后，SFI和清醒血压之间没有独立的联系。
Arousal from sleep produces transient increases in systemic blood pressure, leading to the suggestion that repeated arousals are associated with a sustained increase in daytime blood pressure. Using data from the Wisconsin Sleep Cohort Study, a population-based study, we tested the hypothesis that sleep fragmentation is associated with elevated awake blood pressure. Sleep, breathing, and seated blood pressure measurements from 1,021 participants (age 42 +/- 8 yr; 590 males) were analyzed. Sleep fragmentation was defined as the total number of awakenings and shifts to Stage 1 sleep divided by the total sleep time (sleep fragmentation index: SFI). To reduce the confounding influence of sleep-disordered breathing, which is related to both increased daytime blood pressure and sleep fragmentation, all participants with an apnea-hypopnea index (AHI) greater than or equal to 1 were analyzed separately. Accounting for the influences of sex, age, body mass index, and antihypertensive medication use, the SFI was significantly associated with higher levels of awake systolic blood pressure in people with an AHI < 1; a 2 standard deviation increase in the SFI was associated with a 3.1 mm Hg rise in awake systolic: blood pressure. in participants with an AHI 1, there was no independent association between the SFI and awake blood pressure after controlling for the influence of the AHI.