Tveit Ragnhild L, Lehmann Sverre, Bjorvatn Bjørn
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
PLoS One. 2018 Feb 23;13(2):e0192671. doi: 10.1371/journal.pone.0192671. eCollection 2018.
The objective was to investigate the prevalence of heart attack, angina pectoris, stroke, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, asthma and obesity in relation to the presence and severity of obstructive sleep apnea.
The sample consisted of 1887 patients, with mean age of 48.6 years (range 16-83 years), referred to a university hospital on suspicion of obstructive sleep apnea. The patients filled out a questionnaire asking whether they were previously diagnosed with the comorbidities in interest. Obstructive sleep apnea was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor. The patients' weight, height and blood pressure were measured during the consultations.
In total, 37.9% were categorized as not having obstructive sleep apnea (Apnea-hypopnea index <5), 29.6% mild obstructive sleep apnea (Apnea-hypopnea index 5-14.9), 17.3% moderate obstructive sleep apnea (Apnea-hypopnea index 15-29.9), and 15.2% severe obstructive sleep apnea (Apnea-hypopnea index ≥30). The prevalence of heart attack, angina pectoris, hypertension, measured systolic blood pressure ≥140 mmHg, measured diastolic blood pressure ≥90 mmHg, diabetes mellitus and obesity (body mass index≥30) were higher with greater obstructive sleep apnea severity. Logistic and linear regression analyses showed that these comorbidities were positively associated with obstructive sleep apnea severity. This was not the case for stroke, chronic obstructive pulmonary disease and asthma. After adjustment for sex, age, alcohol and smoking in the logistic regression analyses, hypertension, measured systolic blood pressure ≥140 mmHg, measured diastolic blood pressure ≥90 mmHg and obesity remained positively associated with obstructive sleep apnea severity.
A higher prevalence of heart attack, angina pectoris, hypertension, diabetes mellitus, and obesity was seen with greater obstructive sleep apnea severity. Obesity and hypertension, conditions easy to clinically assess, appear as the most central comorbidities with greater obstructive sleep apnea severity.
本研究旨在调查与阻塞性睡眠呼吸暂停的存在及严重程度相关的心脏病发作、心绞痛、中风、高血压、糖尿病、慢性阻塞性肺疾病、哮喘和肥胖症的患病率。
样本包括1887例患者，平均年龄48.6岁（范围16 - 83岁），因疑似阻塞性睡眠呼吸暂停被转诊至一家大学医院。患者填写一份问卷，询问他们之前是否被诊断患有相关合并症。阻塞性睡眠呼吸暂停通过使用3型便携式监测仪的标准呼吸多导睡眠图研究进行诊断和分类。在会诊期间测量患者的体重、身高和血压。
总体而言，37.9%被归类为无阻塞性睡眠呼吸暂停（呼吸暂停低通气指数<5），29.6%为轻度阻塞性睡眠呼吸暂停（呼吸暂停低通气指数5 - 14.9），17.3%为中度阻塞性睡眠呼吸暂停（呼吸暂停低通气指数15 - 29.9），15.2%为重度阻塞性睡眠呼吸暂停（呼吸暂停低通气指数≥30）。心脏病发作、心绞痛、高血压（收缩压测量值≥140 mmHg，舒张压测量值≥90 mmHg）、糖尿病和肥胖症（体重指数≥30）的患病率随着阻塞性睡眠呼吸暂停严重程度的增加而升高。逻辑回归和线性回归分析表明，这些合并症与阻塞性睡眠呼吸暂停严重程度呈正相关。中风、慢性阻塞性肺疾病和哮喘并非如此。在逻辑回归分析中对性别、年龄、饮酒和吸烟进行调整后，高血压（收缩压测量值≥140 mmHg，舒张压测量值≥90 mmHg）和肥胖症仍与阻塞性睡眠呼吸暂停严重程度呈正相关。
随着阻塞性睡眠呼吸暂停严重程度的增加，心脏病发作、心绞痛、高血压、糖尿病和肥胖症的患病率更高。肥胖症和高血压是临床易于评估的病症，似乎是与阻塞性睡眠呼吸暂停严重程度增加最为相关的合并症。
