Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Department of General Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Sleep Breath. 2019 Mar;23(1):87-94. doi: 10.1007/s11325-018-1664-0. Epub 2018 May 19.
It was shown in a previous cohort study that men with internal carotid artery (ICA) plaque, defined as focal wall thickness of ≥ 1.5 mm, had a threefold higher risk of stroke than those without plaque. We examined the relationship between arousal indices and sleep stages in patients with obstructive sleep apnea syndrome (OSAS) and carotid atherosclerosis.
Carotid atherosclerosis severity was evaluated using the maximal carotid wall intima-media thickness of the ICA (ICA-maxIMT) and plaque in 83 patients with OSAS.
The ICA-maxIMT values were positively correlated with the apnea hypopnea index (AHI) (ρ = 0.294, P = 0.007), arousal index (ρ = 0.289, P = 0.008), oxygen desaturation index (ρ = 0.298, P = 0.006), percentage of visually scored total sleep time spent in nocturnal oxygen saturation < 90% (SpO < 90%) (ρ = 0.246, P = 0.025), and the percentage of visually scored total sleep time spent in non-REM sleep stage 1 (ρ = 0.326, P = 0.003) and were negatively correlated with the percentage of visually scored total sleep time spent in non-REM sleep stages 2 and 3. Arousal index, diabetes mellitus, and age were found to be independent predictors of ICA plaque presence (OR 1.052, P = 0.003; OR 8.705, P = 0.026; OR 1.064, P = 0.023, respectively).
Several PSG variables that are indicative of sleep fragmentation, sleep disordered breathing, and poor sleep quality correlated with the occurrence of atherosclerosis, but total arousal index was the only independent predictive factor.
先前的一项队列研究表明，颈内动脉（ICA）斑块患者（定义为局部管壁厚度≥1.5 毫米）发生中风的风险是无斑块患者的三倍。我们研究了阻塞性睡眠呼吸暂停综合征（OSAS）和颈动脉粥样硬化患者的觉醒指数与睡眠阶段之间的关系。
通过颈内动脉最大内膜中层厚度（ICA-maxIMT）和斑块评估颈动脉粥样硬化严重程度，共评估了 83 例 OSAS 患者。
ICA-maxIMT 值与呼吸暂停低通气指数（AHI）（ρ=0.294，P=0.007）、觉醒指数（ρ=0.289，P=0.008）、氧减饱和度指数（ρ=0.298，P=0.006）、总睡眠时间中夜间血氧饱和度<90%（SpO <90%）的视觉评分百分比（ρ=0.246，P=0.025）和非快速眼动睡眠 1 期的总睡眠时间的视觉评分百分比（ρ=0.326，P=0.003）呈正相关，与非快速眼动睡眠 2 期和 3 期的总睡眠时间的视觉评分百分比呈负相关。觉醒指数、糖尿病和年龄是 ICA 斑块存在的独立预测因素（OR 1.052，P=0.003；OR 8.705，P=0.026；OR 1.064，P=0.023）。
几个提示睡眠片段化、睡眠呼吸紊乱和睡眠质量差的 PSG 变量与动脉粥样硬化的发生相关，但总的觉醒指数是唯一的独立预测因素。
