Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
Sleep. 2018 Jul 1;41(7). doi: 10.1093/sleep/zsy099.
Although obstructive sleep apnea (OSA) is associated with overall cardiovascular disease and mortality, the association with atherosclerotic cardiovascular disease is less clear, especially in women. Recently, it has been suggested that OSA during rapid eye movement (REM) sleep, associated with long apneas and deep desaturations, could have severe cardiometabolic consequences. The aim of this study was to investigate whether OSA during REM sleep is associated with early signs of atherosclerosis in a population-based sample of women.
In the community-based "Sleep and Health in Women" (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements, blood sampling, blood pressure measurement, and answered questionnaires. Ten years later, 201 of the original participants, free of known atherosclerotic disease at baseline and without continuous positive airway pressure treatment for OSA, underwent a high-frequency ultrasound of the common carotid artery to assess the individual thickness of the layers of the artery wall.
Severe OSA during REM sleep (REM apnea-hypopnea index [AHI] ≥ 30) was associated with a thicker intima. This association was still significant after adjustment for age, body mass index, alcohol, and smoking, as well as for further adjustment for systolic blood pressure, low-density lipoprotein, C-reactive protein, and diabetes (β-coefficient, 0.008; p-value, 0.022). The association between a REM AHI of ≥30 and intima thickness was also seen in women with no or mild OSA and normal non-REM AHI.
In this study of a community-based sample of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis.
尽管阻塞性睡眠呼吸暂停（OSA）与整体心血管疾病和死亡率相关，但与动脉粥样硬化性心血管疾病的关联尚不清楚，尤其是在女性中。最近，有人提出，快速眼动（REM）睡眠期间与长暂停和深度脱氧相关的 OSA 可能会产生严重的心脏代谢后果。本研究旨在调查 REM 睡眠期间的 OSA 是否与基于人群的女性样本中动脉粥样硬化的早期迹象有关。
在基于社区的“女性睡眠与健康”（SHE）队列研究中，400 名女性接受了多导睡眠图、人体测量学测量、血液采样、血压测量和问卷调查。十年后，在最初的 400 名参与者中，有 201 名基线时无已知动脉粥样硬化疾病且未接受持续气道正压通气治疗 OSA 的参与者接受了颈总动脉高频超声检查，以评估动脉壁各层的个体厚度。
REM 睡眠期间严重的 OSA（REM 呼吸暂停低通气指数[AHI]≥30）与内膜增厚有关。这种关联在调整年龄、体重指数、酒精和吸烟以及进一步调整收缩压、低密度脂蛋白、C 反应蛋白和糖尿病后仍然显著（β系数，0.008；p 值，0.022）。在无或轻度 OSA 和正常非 REM AHI 的女性中，REM AHI≥30 与内膜厚度之间的关联仍然存在。
在这项基于社区的女性样本研究中，REM 睡眠期间严重的 OSA 与动脉粥样硬化的早期迹象独立相关。
