Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium.
Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium.
Sleep Med. 2019 Jan;53:115-123. doi: 10.1016/j.sleep.2018.08.030. Epub 2018 Oct 4.
Given conflicting data in the literature, the aim of this study was to examine the risk of high blood pressure (HBP) associated with sleep alterations, measured during polysomnography, and long-term use of benzodiazepine receptor agonists in a large sample of individuals with insomnia.
Demographic and polysomnographic data from 1272 individuals with insomnia recruited from the research database of the sleep laboratory of Erasme Hospital were analyzed. HBP status was defined by the presence of one of the following: self-report at interview of either a physician's diagnosis or taking antihypertensive medication; or an average systolic blood pressure ≥140 mm Hg or an average diastolic blood pressure ≥90 mm Hg at the medical examination. Logistic regression analyses were conducted to examine the risk of HBP associated with objective sleep alterations and long-term use of benzodiazepine receptor agonists in individuals with insomnia.
The prevalence of HBP in individuals with insomnia is 30.03%. After adjustment for major confounding factors associated with HBP, multivariate logistic regression analysis revealed that short sleep duration (<5 h), severely reduced sleep efficiency (<65%), high sleep fragmentation (sleep fragmentation index ≥18/h), and long-term use of short or intermediate half-life benzodiazepine receptor agonists were significant risk factors for HBP in individuals with insomnia.
In individuals with insomnia, objective sleep alterations and long-term use of short or intermediate half-life benzodiazepine receptor agonists are associated with higher risk of HBP. Therefore, better management of these reversible risk factors is required to avoid the negative consequences of the co-occurrence of insomnia and HBP.
由于文献中存在相互矛盾的数据，本研究旨在探讨在大量失眠患者中，通过多导睡眠图测量的睡眠改变以及苯二氮䓬受体激动剂的长期使用与高血压（HBP）风险之间的关系。
分析了来自伊拉斯谟医院睡眠实验室研究数据库的 1272 名失眠患者的人口统计学和多导睡眠图数据。HBP 状态通过以下标准之一来定义：访谈时自我报告医生诊断或服用抗高血压药物；或在体检时平均收缩压≥140mmHg 或平均舒张压≥90mmHg。采用逻辑回归分析来检查失眠患者中与客观睡眠改变和长期使用苯二氮䓬受体激动剂相关的 HBP 风险。
失眠患者中 HBP 的患病率为 30.03%。在调整与 HBP 相关的主要混杂因素后，多变量逻辑回归分析显示，短睡眠时间（<5 小时）、严重降低的睡眠效率（<65%）、高睡眠片段化（睡眠片段化指数≥18/小时）和长期使用短或中半衰期苯二氮䓬受体激动剂是失眠患者发生 HBP 的显著危险因素。
在失眠患者中，客观睡眠改变和长期使用短或中半衰期苯二氮䓬受体激动剂与 HBP 的风险增加相关。因此，需要更好地管理这些可逆转的危险因素，以避免失眠和 HBP 同时发生的负面影响。
