Contribution of male sex, age, and obesity to mechanical instability of the upper airway during sleep
Contribution of male sex, age, and obesity to mechanical instability of the upper airway during sleep
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DOI：
10.1152/japplphysiol.00045.2008
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发表时间：
2008-06-01
影响因子：
3.3
通讯作者：
Patil, Susheel P.
中科院分区：
文献类型：
--
作者：
Kirkness, Jason P.;Schwartz, Alan R.;Patil, Susheel P.
男性、肥胖和年龄是阻塞性睡眠呼吸暂停的危险因素，尽管这些因素增加睡眠呼吸暂停易感性的机制尚不完全清楚。本研究探讨了睡眠呼吸暂停危险因素、上呼吸道力学和睡眠呼吸暂停易感性之间的相互关系。在164名（86名男性，78名女性）有和没有睡眠呼吸暂停的参与者中，对上气道压力-流量关系进行了表征，以确定其在非快速眼动睡眠期间的机械特性[低渗条件下的咽部临界压力（被动Pcrit）]。在多元线性回归分析中，确定了每种性别的体重指数和年龄对被动Pcrit的影响。一个由体重指数、年龄和疾病严重程度匹配的男性和女性子集被用来确定性别对被动Pcrit的影响。在匹配体重指数、年龄和疾病严重程度后，女性的被动Pcrit比男性低1.9 cmH（2）O [95%置信区间（CI）：0.1-3.6 cmH（2）O]。被动Pcrit和睡眠呼吸暂停状态和严重程度之间的关系进行了研究。在被动Pcrit低于-5 cmH（2）O的个体中，睡眠呼吸暂停基本上不存在，当被动Pcrit升高到-5 cmH（2）O以上时，睡眠呼吸暂停的严重程度显著增加。被动Pcrit预测睡眠呼吸暂停状态的预测能力为0.73（95%CI：0.65-0.82）。上呼吸道力学受性别、肥胖和年龄的不同控制，并部分介导这些睡眠呼吸暂停危险因素与阻塞性睡眠呼吸暂停之间的关系。
Male sex, obesity, and age are risk factors for obstructive sleep apnea, although the mechanisms by which these factors increase sleep apnea susceptibility are not entirely understood. This study examined the interrelationships between sleep apnea risk factors, upper airway mechanics, and sleep apnea susceptibility. In 164 (86 men, 78 women) participants with and without sleep apnea, upper airway pressure-flow relationships were characterized to determine their mechanical properties [pharyngeal critical pressure under hypotonic conditions (passive Pcrit)] during non-rapid eye movement sleep. In multiple linear regression analyses, the effects of body mass index and age on passive Pcrit were determined in each sex. A subset of men and women matched by body mass index, age, and disease severity was used to determine the sex effect on passive Pcrit. The passive Pcrit was 1.9 cmH(2)O [95% confidence interval (CI): 0.1-3.6 cmH(2)O] lower in women than men after matching for body mass index, age, and disease severity. The relationship between passive Pcrit and sleep apnea status and severity was examined. Sleep apnea was largely absent in those individuals with a passive Pcrit less than -5 cmH(2)O and increased markedly in severity when passive Pcrit rose above -5 cmH(2)O. Passive Pcrit had a predictive power of 0.73 (95% CI: 0.65-0.82) in predicting sleep apnea status. Upper airway mechanics are differentially controlled by sex, obesity, and age, and partly mediate the relationship between these sleep apnea risk factors and obstructive sleep apnea.