Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.
Sleep Med. 2009 Aug;10(7):720-5. doi: 10.1016/j.sleep.2008.07.010. Epub 2008 Oct 25.
The aim of the current study was to investigate whether changes in post- to pre-overnight sleep systolic blood pressure (SSBP) are associated with sleep respiratory disturbance, pro-inflammatory state, and metabolic situation in patients with sleep-disordered breathing (SDB).
Anthropometry, sleep polysomnography, biochemical markers, and pre- and post-overnight sleep BP were measured from 263 SDB patients. All SDB patients were further subgrouped into MORNING SURGE (% changes from post- to pre-overnight SSBP >+1SD of this cohort), MORNING DROP (% changes <-1SD), CONSTANT HIGH (% changes within+/-1SD, averaged SSBP>130mmHg) and CONSTANT LOW (% changes within+/-1SD, averaged SSBP<130mmHg).
BMI, neck circumference, waistline circumference, respiratory disturbance index, arousal index, lowest oxygen saturation, duration of SaO(2)<90%, blood glucose, hs-CRP, and metabolic syndrome score in MORNING SURGE and CONSTANT HIGH were significantly greater than those in CONSTANT LOW. Except metabolic syndrome score, all other parameters in MORNING DROP were similar to those in CONSTANT LOW.
Patients with SDB whose post- to pre-overnight SSBPs were elevated or maintained a constant high have more sleep respiratory disturbance, more pro-inflammatory state, and higher metabolic syndrome indices than the rest. Without subdividing into CONSTANT LOW, MORNING DROP, CONSTANT HIGH, and MORNING SURGE, the important pathophysiologic points of SDB patients will possibly be missed.
本研究旨在探讨睡眠呼吸紊乱患者,隔夜前后收缩压(SSBP)的变化是否与睡眠呼吸障碍、促炎状态和代谢状况有关。
从 263 例睡眠呼吸紊乱患者中测量了人体测量学、睡眠多导睡眠图、生化标志物以及隔夜前后的睡眠血压。所有睡眠呼吸紊乱患者进一步分为晨峰组(%变化从隔夜后到前一晚 SSBP>+1SD 为该队列的 1SD)、晨降组(%变化<-1SD)、持续高组(%变化在+/-1SD 内,平均 SSBP>130mmHg)和持续低组(%变化在+/-1SD 内,平均 SSBP<130mmHg)。
在晨峰组和持续高组中,BMI、颈围、腰围、呼吸紊乱指数、觉醒指数、最低血氧饱和度、SaO(2)<90%的持续时间、血糖、hs-CRP 和代谢综合征评分显著高于持续低组。除代谢综合征评分外,晨降组的所有其他参数均与持续低组相似。
与持续低组相比,隔夜前后 SSBP 升高或维持在较高水平的睡眠呼吸紊乱患者具有更多的睡眠呼吸障碍、更明显的促炎状态和更高的代谢综合征指数。如果不分为持续低组、晨降组、持续高组和晨峰组,可能会错过睡眠呼吸紊乱患者的重要病理生理要点。