Mills Paul J, Kim Jong-Heun, Bardwell Wayne, Hong Suzi, Dimsdale Joel E
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
Sleep Breath. 2008 Nov;12(4):397-9. doi: 10.1007/s11325-008-0192-8. Epub 2008 May 31.
The objective of this study was to determine potential inflammatory predictors of fatigue in obstructive sleep apnea (OSA).
Fifty-six women and men untreated OSA patients had their sleep monitored with polysomnography. Fatigue was assessed by the Multidimensional Fatigue Symptom Inventory-Short Form. Depressed mood was assessed by the Center for Epidemiologic Studies-Depression Scale. Blood was drawn to assess circulating levels of Interleukin-6 (IL-6) and soluble tumor necrosis factor receptor I (sTNF-RI). Age, gender, body mass index (BMI), blood pressure, OSA severity, depressed mood, and inflammatory biomarkers were entered into a hierarchical multiple linear regression analysis predicting self-reported fatigue.
Approximately 42% of the patients reported significant amounts of fatigue. Higher BMI (p = 0.014), greater depressed mood (p = 0.004), and higher sTNF-RI levels (p = 0.033) were independent predictors of fatigue in the final model (full model R2 = .571; p = .003). Age, gender, blood pressure and apnea severity were unrelated to fatigue.
The findings suggest that in addition to depressed mood, fatigue in OSA may be associated with increased body weight and elevated levels of the proinflammatory cytokine receptor sTNF-RI. The findings support a linkage between the widely reported fatigue in OSA and a sleep-related component of inflammation.
本研究的目的是确定阻塞性睡眠呼吸暂停(OSA)患者疲劳的潜在炎症预测指标。
56名未经治疗的OSA男女患者通过多导睡眠图监测睡眠情况。采用多维疲劳症状量表简表评估疲劳程度。采用流行病学研究中心抑郁量表评估抑郁情绪。抽取血液检测白细胞介素-6(IL-6)和可溶性肿瘤坏死因子受体I(sTNF-RI)的循环水平。将年龄、性别、体重指数(BMI)、血压、OSA严重程度、抑郁情绪和炎症生物标志物纳入分层多元线性回归分析,以预测自我报告的疲劳情况。
约42%的患者报告有明显的疲劳感。在最终模型中,较高的BMI(p = 0.014)、更严重的抑郁情绪(p = 0.004)和较高的sTNF-RI水平(p = 0.033)是疲劳的独立预测因素(完整模型R2 = 0.571;p = 0.003)。年龄、性别、血压和呼吸暂停严重程度与疲劳无关。
研究结果表明,除了抑郁情绪外,OSA患者的疲劳可能与体重增加和促炎细胞因子受体sTNF-RI水平升高有关。这些发现支持了OSA中广泛报道的疲劳与睡眠相关炎症成分之间的联系。