Ruel G, Martin S A, Lévesque J-F, Wittert G A, Adams R J, Appleton S L, Shi Z, Taylor A W
Direction québécoise du cancer, Ministère de la Santé et des Services sociaux, Québec, Canada.
Centre de recherche du CHUM, Université de Montréal, Montréal, Canada.
Glob Health Epidemiol Genom. 2018 Jun 4;3:e10. doi: 10.1017/gheg.2018.9. eCollection 2018.
Multimorbidity is common but little is known about its relationship with obstructive sleep apnea (OSA).
Men Androgen Inflammation Lifestyle Environment and Stress Study participants underwent polysomnography. Chronic diseases (CDs) were determined by biomedical measurement (diabetes, dyslipidaemia, hypertension, obesity), or self-report (depression, asthma, cardiovascular disease, arthritis). Associations between CD count, multimorbidity, apnea-hyponea index (AHI) and OSA severity and quality-of-life (QoL; mental & physical component scores), were determined using multinomial regression analyses, after adjustment for age.
Of the 743 men participating in the study, overall 58% had multimorbidity (2+ CDs), and 52% had OSA (11% severe). About 70% of those with multimorbidity had undiagnosed OSA. Multimorbidity was associated with AHI and undiagnosed OSA. Elevated CD count was associated with higher AHI value and increased OSA severity.
We demonstrate an independent association between the presence of OSA and multimorbidity in this representative sample of community-based men. This effect was strongest in men with moderate to severe OSA and three or more CDs, and appeared to produce a greater reduction in QoL when both conditions were present together.
多病共存很常见，但关于其与阻塞性睡眠呼吸暂停（OSA）的关系却知之甚少。
男性雄激素、炎症、生活方式、环境与压力研究的参与者接受了多导睡眠图检查。慢性病（CDs）通过生物医学测量（糖尿病、血脂异常、高血压、肥胖症）或自我报告（抑郁症、哮喘、心血管疾病、关节炎）来确定。在对年龄进行调整后，使用多项回归分析确定CD计数、多病共存、呼吸暂停低通气指数（AHI）与OSA严重程度及生活质量（QoL；心理和身体成分得分）之间的关联。
在参与研究的743名男性中，总体上58%患有多病共存（两种及以上慢性病），52%患有OSA（11%为重度）。多病共存者中约70%患有未确诊的OSA。多病共存与AHI及未确诊的OSA相关。CD计数升高与更高的AHI值及OSA严重程度增加相关。
在这个具有代表性的社区男性样本中，我们证明了OSA的存在与多病共存之间存在独立关联。这种效应在患有中度至重度OSA且有三种及以上慢性病的男性中最为明显，并且当两种情况同时存在时，似乎会对生活质量产生更大的降低。
