Hirshkowitz M, Karacan I, Gurakar A, Williams R L
Department of Psychiatry, Baylor College of Medicine, Houston, Texas.
Sleep. 1989 Jun;12(3):223-32. doi: 10.1093/sleep/12.3.223.
Sleep-related respiratory pattern was evaluated in 175 hypertensive and 110 normotensive men, none of whom reported difficulties in initiating or maintaining sleep. Patients were grouped according to sexual status (complaint of erectile problems), hypertension treatment status (treated or untreated), and blood pressure (diastolic less than 90 or greater than or equal to 90). The prevalence of sleep apnea, apnea index, duration of the longest episode of apnea, and penile rigidity were tabulated. The group with elevated blood pressure, persistent even with antihypertensive drug therapy, had the most sleep apnea. The treated hypertensive men with controlled blood pressure had significantly less apnea than those whose blood pressure remained high. Untreated hypertensive groups, however, did not differ from normotensive groups with respect to apnea. Evidence of abnormal sleep-related respiratory activity was found in both hypertensive and normotensive groups with erectile problems. Interestingly, penile rigidity was significantly lower for hypertensive men with erectile complaints than for normotensive men with erectile complaints. There was also a small, but significant, negative correlation between apnea index and penile rigidity among men with erectile complaints. These results indicate that sexual status is an important consideration in the diagnosis of hypertension and sleep apnea. Moreover, these data suggest an interrelationship among hypertension, erectile dysfunction, and sleep apnea.
对175名高血压男性和110名血压正常男性的睡眠相关呼吸模式进行了评估，他们均未报告入睡或维持睡眠困难。患者根据性功能状态（勃起功能障碍主诉）、高血压治疗状态（治疗或未治疗）和血压（舒张压低于90或大于或等于90）进行分组。对睡眠呼吸暂停的患病率、呼吸暂停指数、最长呼吸暂停发作持续时间和阴茎硬度进行了列表统计。血压升高的组，即使接受抗高血压药物治疗后仍持续升高，其睡眠呼吸暂停情况最为严重。血压得到控制的接受治疗的高血压男性的呼吸暂停明显少于血压仍高的男性。然而，未治疗的高血压组在呼吸暂停方面与血压正常组并无差异。在有勃起功能障碍的高血压组和血压正常组中均发现了与睡眠相关的异常呼吸活动证据。有趣的是，有勃起功能障碍主诉的高血压男性的阴茎硬度明显低于有勃起功能障碍主诉的血压正常男性。在有勃起功能障碍主诉的男性中，呼吸暂停指数与阴茎硬度之间也存在微小但显著的负相关。这些结果表明，性功能状态是高血压和睡眠呼吸暂停诊断中的一个重要考虑因素。此外，这些数据表明高血压、勃起功能障碍和睡眠呼吸暂停之间存在相互关系。
