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睡眠呼吸暂停和基于活动记录仪的睡眠时长与西班牙裔社区健康研究/拉丁裔研究样本中的脑血流动力学。

Cerebral Hemodynamics in Sleep Apnea and Actigraphy-Determined Sleep Duration in a Sample of the Hispanic Community Health Study/ Study of Latinos.

机构信息

Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida.

Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

出版信息

J Clin Sleep Med. 2019 Jan 15;15(1):15-21. doi: 10.5664/jcsm.7560.

Abstract

STUDY OBJECTIVES

We sought to evaluate cerebral hemodynamics in obstructive sleep apnea (OSA) and actigraphy-defined short sleep duration using transcranial Doppler ultrasound (TCD) blood flow velocity in a subsample of Hispanics/Latinos without stroke and cardiovascular disease.

METHODS

The sample consisted of consecutive participants at the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with overnight home sleep testing and 7 days of wrist actigraphy in the Sueño sleep ancillary study. Ninety-five participants had sleep data and TCD determined cerebral hemodynamics. We evaluated the association between OSA (apnea-hypopnea index [AHI] ≥ 5 events/h) and short sleep duration (< 6.8 hours; sample median) with cerebral blood flow velocities (CBFV) and pulsatility index (PI) for the middle cerebral (MCA) and basilar arteries (BA).

RESULTS

Median age was 48 years (range 20-64) with 71% females. Twenty-eight percent of the sample had OSA (AHI ≥ 5 events/h) with median AHI of 10.0 (range 5.0-51.7) events/h. In unadjusted analyses, participants with OSA had lower median CBFV in the BA (30.5 cm/s [interquartile range:10.2] versus 39.4 cm/s [13.3] < .05), but not the MCA, whereas short sleepers had higher median vascular resistance in the MCA (PI = 0.92 [0.18] versus 0.86 [0.14] < .05) and BA (PI = 1.0 [0.17] versus 0.93 [0.24] < .05). After full adjustment, OSA was associated with decreased CBFV (β [SE] = -5.1 [2.5] < .05) in the BA. Short sleep was associated with increased PI (β [SE] = 0.05 [0.02] < .05) in the MCA.

CONCLUSIONS

In this sample of Hispanic/Latinos, OSA was associated with decreased daytime blood flow velocity in the BA, whereas actigraphy-defined short sleep duration was associated with increased cerebrovascular pulsatility in the MCA.

摘要

研究目的

我们试图使用经颅多普勒超声(TCD)血流速度评估阻塞性睡眠呼吸暂停(OSA)和活动记录仪定义的短睡眠时间的脑血流动力学,研究对象为无中风和心血管疾病的西班牙裔/拉丁裔人群中的亚组。

方法

本研究样本来自迈阿密的西班牙裔社区健康研究/拉丁裔研究(HCHS/SOL)中的连续参与者,他们在 Sueño 睡眠辅助研究中接受了过夜家庭睡眠测试和 7 天手腕活动记录仪监测。95 名参与者有睡眠数据和 TCD 确定的脑血流动力学数据。我们评估了 OSA(呼吸暂停低通气指数[AHI]≥5 次/小时)和短睡眠时间(<6.8 小时;样本中位数)与大脑中动脉(MCA)和基底动脉(BA)的脑血流速度(CBFV)和搏动指数(PI)之间的关联。

结果

中位年龄为 48 岁(范围 20-64 岁),女性占 71%。28%的样本患有 OSA(AHI≥5 次/小时),中位 AHI 为 10.0(范围 5.0-51.7)次/小时。在未调整的分析中,患有 OSA 的参与者 BA 的 CBFV 中位数较低(30.5cm/s [四分位距:10.2] 与 39.4cm/s [13.3] <.05),但 MCA 没有,而睡眠不足者 MCA 的血管阻力中位数较高(PI=0.92 [0.18] 与 0.86 [0.14] <.05)和 BA(PI=1.0 [0.17] 与 0.93 [0.24] <.05)。在完全调整后,OSA 与 BA 的 CBFV 降低相关(β[SE]=-5.1[2.5] <.05)。短睡眠时间与 MCA 的 PI 增加相关(β[SE]=0.05[0.02] <.05)。

结论

在这项西班牙裔/拉丁裔人群样本中,OSA 与 BA 白天血流速度降低有关,而活动记录仪定义的短睡眠时间与 MCA 中脑血管搏动增加有关。

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