Objective but Not Subjective Short Sleep Duration Is Associated With Hypertension in Obstructive Sleep Apnea.
Objective but Not Subjective Short Sleep Duration Is Associated With Hypertension in Obstructive Sleep Apnea.
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客观而非主观的睡眠时间短与阻塞性睡眠呼吸暂停的高血压相关
DOI：
10.1161/hypertensionaha.118.11027
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发表时间：
2018-09
期刊：
影响因子：
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通讯作者：
Tang X
中科院分区：
文献类型：
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作者：
Ren R;Covassin N;Yang L;Li Y;Zhang Y;Zhou J;Tan L;Li T;Li X;Wang Y;Zhang J;Wing YK;Li W;Somers VK;Tang X
极端的睡眠时间和阻塞性睡眠呼吸暂停（OSA）都与高血压有关。我们的目的是探讨睡眠时间是否改变OSA和高血压之间的关系，使用客观和主观的总睡眠时间测量。共纳入7107例OSA患者和1118例原发性打鼾者。高血压的定义是基于直接的血压测量或医生的诊断。客观睡眠时间由多导睡眠仪得出，主观睡眠时间由自我报告。采用Logistic回归模型估计OSA患者和原发性打鼾患者的客观/主观睡眠时间与高血压患病率之间的关系。与原发性打鼾者相比，OSA合并客观睡眠时间为5 ~ 6小时使高血压的发生率增加45%（优势比为1.45；95%可信区间为1.14 ~ 1.84），而OSA合并客观睡眠时间<5小时使高血压的发生率进一步增加80%（优势比为1.80；95%可信区间为1.33 ~ 2.42）。这些结果与经常与OSA或高血压相关的主要混杂因素无关。在睡眠时间的分层分析中，睡眠时间极短（<5小时）的高血压风险在OSA和原发性打鼾者之间没有显著差异，而在其他4个睡眠时间层（5 - 6,6 - 7,7 - 8和bbb8小时）中，OSA的风险显著差异。使用主观睡眠时间无明显意义。我们得出结论，客观睡眠时间短与OSA患者高血压有关。就高血压风险而言，极短的睡眠时间本身可能比阻塞性睡眠呼吸暂停更有害。
Extremes of sleep duration and obstructive sleep apnea (OSA) are both associated with hypertension. We aimed to explore whether sleep duration modifies the relationship between OSA and prevalent hypertension, using both objective and subjective measures of total sleep duration. A total of 7107 OSA patients and 1118 primary snorers were included in the study. Hypertension was defined based either on direct blood pressure measures or on diagnosis by a physician. Objective sleep duration was derived by polysomnography and subjective sleep duration was self-reported. Logistic regression models were used to estimate the associations between objective/subjective sleep duration and hypertension prevalence in OSA and primary snorers. Compared with primary snorers, OSA combined with objective sleep duration of 5 to 6 hours increased the odds of hypertension by 45% (odds ratio, 1.45; 95% confidence interval, 1.14–1.84), whereas OSA combined with objective sleep duration <5 hours further increased the odds of hypertension by 80% (odds ratio, 1.80; 95% confidence interval, 1.33–2.42). These results were independent of major confounding factors frequently associated with OSA or hypertension. In stratified analysis by sleep duration, risk of hypertension in those with extremely short sleep (<5 hours) was not significantly different between OSA and primary snorers, whereas odds were significant for OSA in the other 4 sleep duration strata (5–6, 6–7, 7–8, and >8 hours). No significance was evident using subjective sleep duration. We conclude that objective short sleep duration is associated with hypertension in OSA patients. Extremely short sleep duration in itself may actually be even more detrimental than OSA in terms of hypertension risk.