原发性头痛障碍患者睡眠呼吸暂停风险增加：一项全国范围内基于人群的纵向研究。

Increased risk of sleep apnoea among primary headache disorders: a nationwide population-based longitudinal study.

机构信息

Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Division of Neurology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.

出版信息

Postgrad Med J. 2019 Feb;95(1120):72-77. doi: 10.1136/postgradmedj-2018-136220. Epub 2019 Apr 1.

DOI:10.1136/postgradmedj-2018-136220

PMID:30936249

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6581072/

Abstract

BACKGROUND

Primary headache disorders (PHDs) are associated with sleep problems. It is suggested that headache and sleep disorder share anatomical and physiological characteristics. We hypothesised that patients with PHDs were exposed to a great risk for developing sleep apnoea (SA).

METHODS

In this retrospective longitudinal study, the data obtained from the Longitudinal Health Insurance Database in Taiwan were analysed. The study included 1346 patients with PHDs who were initially diagnosed and 5348 patients who were randomly selected and age/sex matched with the study group as controls. PHDs, SA, comorbidities and other confounding factors were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification. Cox proportional hazards regressions were employed to examine adjusted HRs after adjusting with confounding factors.

RESULTS

Our data revealed that patients with PHDs had a higher risk (HR 2.17, 95% CI 1.259 to 3.739, p<0.05) to develop SA compared with matched cohorts, whereas patients with migraine exhibited a high risk (HR 2.553, 95% CI 1.460 to 4.395, p<0.01). The results showed that patients with PHDs aged 18-44 exhibited highest risk of developing SA. In addition, males with PHDs exhibited an HR 3.159 (95% CI 1.479 to 6.749, p<0.01) for developing SA, respectively. The impact of PHDs on SA risk was progressively increased by various follow-up time intervals.

CONCLUSION

Our results suggest that PHDs are linked to an increased risk for SA with sex-dependent and time-dependent characteristics.

摘要

背景

原发性头痛障碍（PHD）与睡眠问题有关。有人认为头痛和睡眠障碍具有解剖和生理特征。我们假设 PHD 患者发生睡眠呼吸暂停（SA）的风险较大。

方法

在这项回顾性纵向研究中，分析了来自台湾纵向健康保险数据库的数据。该研究纳入了 1346 名最初被诊断为 PHD 的患者和 5348 名随机选择并与研究组年龄/性别匹配的对照患者。根据国际疾病分类，第九版，临床修正版，定义了 PHD、SA、合并症和其他混杂因素。采用 Cox 比例风险回归分析，在调整混杂因素后，检验调整后的 HR。

结果

我们的数据显示，与匹配队列相比，患有 PHD 的患者发生 SA 的风险更高（HR 2.17，95%CI 1.259 至 3.739，p<0.05），而偏头痛患者的风险较高（HR 2.553，95%CI 1.460 至 4.395，p<0.01）。结果表明，18-44 岁的 PHD 患者发生 SA 的风险最高。此外，患有 PHD 的男性发生 SA 的 HR 为 3.159（95%CI 1.479 至 6.749，p<0.01）。PHD 对 SA 风险的影响随着随访时间间隔的不同而逐渐增加。