Ben Halima Afef, Aouadi Samira, Bejjar Dorra, Laroussi Lobna, Boukhris Marouène, Gharbi Leila, Addad Faouzi, Kachboura Salem
Tunis Med. 2018 Mar;96(3):187-192.
Obstructive sleep apnea-hypopnea syndrome (OSAS) and cardiovascular disease are public health problems. The objective of our study was to evaluate the frequency of OSAS in patients with hypertension and atrial fibrillation (AF) and to investigate the factors associated with OSAS in this population.
It's a cross-sectional study including 73patients with hypertension and AF. All patients underwent a respiratory polygraphy.
Seventy-Threepatients were included (57 women). The mean age was 66.6±10.7 years. Obesity was found in 75% of patients. The mean duration of hypertension and AF evolution was respectively 8.7±7.3 years and 4.5±5.6 years.A resistant hypertension was found in 16% of patients. AF was paroxysmal in 34% of patients, persistent in 33% and permanent in 33% of patients.The mean Epworth score was 6.7±6.1 with excessive diurnal somnolence found in 30% of patients. According to the Berlin questionnaire, OSAS was "very likely" in 84% of patients. The prevalence of OSAS in patients with hypertension and AF was 77% with an average HAI of 23.26±19.57 per hour of sleep. OSAS was severe in 44% of patients, moderate in 15% of patients, and mild in 18% of patients. Factors associated with OSAS in our population were cognitive disorders (21% vs 0%, p=0.03), diurnal excessive sleepiness (21% vs. 0%, p=0.05), antiarrythmic therapy (63% vs 29%, p=0.016, OR=4.13, 95% CI 1.25-13.64) and nocturnal desaturation (25.86±17.68 vs 9.15±14.3 / H, p<0.0001). Our study did not find any significant difference between the groups regarding demographic characteristics, anthropometric, ultrasound data of patients and characteristics of hypertension and AF.
OSAS is common among patients followed for hypertension and atrial fibrillation. Its screening is necessary to improve the management and prognosis of these two diseases. However, in the absence of predictive factors for OSA, a polygraph could be recommended for this population.
阻塞性睡眠呼吸暂停低通气综合征（OSAS）和心血管疾病是公共卫生问题。我们研究的目的是评估高血压合并心房颤动（AF）患者中OSAS的发生率，并调查该人群中与OSAS相关的因素。
这是一项横断面研究，纳入了73例高血压合并AF患者。所有患者均接受了呼吸多导睡眠监测。
共纳入73例患者（57例女性）。平均年龄为66.6±10.7岁。75%的患者存在肥胖。高血压和AF的平均病程分别为8.7±7.3年和4.5±5.6年。16%的患者存在顽固性高血压。34%的患者AF为阵发性，33%为持续性，33%为永久性。平均爱泼华嗜睡量表评分为6.7±6.1，30%的患者存在日间过度嗜睡。根据柏林问卷，84%的患者“很可能”患有OSAS。高血压合并AF患者中OSAS的患病率为77%，平均每小时睡眠呼吸暂停低通气指数（HAI）为23.26±19.57。44%的患者OSAS为重度，15%为中度，18%为轻度。我们人群中与OSAS相关的因素包括认知障碍（21%对0%，p=0.03）、日间过度嗜睡（21%对0%，p=0.05）、抗心律失常治疗（分别为63%和29%，p=0.016，OR=4.13，95%CI 1.25-13.64）和夜间低氧血症（25.86±17.68对9.15±14.3次/小时，p<0.0001）。我们的研究未发现两组在患者的人口统计学特征、人体测量学、超声数据以及高血压和AF特征方面存在任何显著差异。
OSAS在高血压合并心房颤动患者中很常见。对其进行筛查对于改善这两种疾病的管理和预后很有必要。然而，在缺乏OSA预测因素的情况下，建议对该人群进行多导睡眠监测。
