Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend
Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend
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DOI：
10.1111/jsr.12770
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发表时间：
2019-10-01
影响因子：
4.4
通讯作者：
Penzel, Thomas
中科院分区：
文献类型：
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作者：
Fietze, Ingo;Laharnar, Naima;Penzel, Thomas
识别阻塞性睡眠呼吸暂停和危险因素对于减少症状和心血管风险以及改善生活质量非常重要。以人口为基础的波美拉尼亚健康研究调查了德国东北部普通人群的危险因素和临床疾病。应用额外的多导睡眠图来测量睡眠和呼吸，目的是评估德国队列中阻塞性睡眠呼吸暂停的患病率和危险因素。对 1000、208 名 20 岁至 81 岁之间的人（54% 为男性，中位年龄 54 岁）进行了夜间多导睡眠监测。呼吸暂停低通气指数 >= 5% 时，估计的阻塞性睡眠呼吸暂停患病率为 46%（男性 59%，女性 33%）；呼吸暂停低通气指数 >= 15 时，估计阻塞性睡眠呼吸暂停患病率为 21%（男性 30%，女性 13%）。估计的阻塞性睡眠呼吸暂停综合征患病率（呼吸暂停低通气指数 >= 5；Epworth 嗜睡量表 >10）为6%。男性和女性阻塞性睡眠呼吸暂停的患病率随着年龄的增长而持续增加，但女性发病较晚。性别、年龄、体重指数、腰臀比、打鼾、饮酒（仅限女性）和自我报告的心血管疾病与阻塞性睡眠呼吸暂停显着正相关，而白天嗜睡则不然。糖尿病、高血压和代谢综合征与严重阻塞性睡眠呼吸暂停呈正相关。调整体重后，这些关联变得不显着。女性比男性表现出更强的联想。阻塞性睡眠呼吸暂停的患病率很高，几乎一半的人口患有某种阻塞性睡眠呼吸暂停。阻塞性睡眠呼吸暂停随着年龄的增长而持续增加，对当前的理论提出了挑战，即阻塞性睡眠呼吸暂停和心血管并发症导致的死亡率会影响高龄阻塞性睡眠呼吸暂停的患病率。此外，阻塞性睡眠呼吸暂停及其关联的性别差异对于识别阻塞性睡眠呼吸暂停机制和治疗反应具有重要意义。
Identification of obstructive sleep apnea and risk factors is important for reduction in symptoms and cardiovascular risk, and for improvement of quality of life. The population-based Study of Health in Pomerania investigated risk factors and clinical diseases in a general population of northeast Germany. Additional polysomnography was applied to measure sleep and respiration with the objective of assessing prevalence and risk factors of obstructive sleep apnea in a German cohort. One-thousand, two-hundred and eight people between 20 and 81 years old (54% men, median age 54 years) underwent overnight polysomnography. The estimated obstructive sleep apnea prevalence was 46% (59% men, 33% women) for an apnea-hypopnea index >= 5%, and 21% (30% men, 13% women) for an apnea-hypopnea index >= 15. The estimated obstructive sleep apnea syndrome prevalence (apnea-hypopnea index >= 5; Epworth Sleepiness Scale >10) was 6%. The prevalence of obstructive sleep apnea continuously increased with age for men and women with, however, later onset for women. Gender, age, body mass index, waist-to-hip ratio, snoring, alcohol consumption (for women only) and self-reported cardiovascular diseases were significantly positively associated with obstructive sleep apnea, whereas daytime sleepiness was not. Diabetes, hypertension and metabolic syndrome were positively associated with severe obstructive sleep apnea. The associations became non-significant after adjustment for body mass. Women exhibited stronger associations than men. The prevalence of obstructive sleep apnea was high, with almost half the population presenting some kind of obstructive sleep apnea. The continuous increase of obstructive sleep apnea with age challenges the current theory that mortality due to obstructive sleep apnea and cardiovascular co-morbidities affect obstructive sleep apnea prevalence at an advanced age. Also, gender differences regarding obstructive sleep apnea and associations are significant for recognizing obstructive sleep apnea mechanisms and therapy responsiveness.