Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida.
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Clin Sleep Med. 2019 Jan 15;15(1):15-21. doi: 10.5664/jcsm.7560.
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.
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).
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.
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.
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。
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。
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)。
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。