University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Sci Rep. 2020 Feb 24;10(1):3342. doi: 10.1038/s41598-020-60281-2.
Rapid eye movement-predominant obstructive sleep apnea has been shown to be independently associated with hypertension. This study aimed to non-invasively measure blood pressure during the rapid eye movement (REM) and non-rapid eye movement (NREM) obstructive events and the post-obstructive event period. Thirty-two consecutive continuous positive airway pressure-naïve obstructive sleep apnea patients (men, 50%) aged 50.2 ± 12 years underwent overnight polysomnography. Blood pressure was assessed indirectly using a validated method based on the pulse transit time and pulse wave velocity during the NREM and REM obstructive events (both apneas and hypopneas) and the post-obstructive event period. Among the recruited patients, 10 (31.3%) had hypertension. Mean apnea-hypopnea index was 40.1 ± 27.6 events/hr. Apnea-hypopnea indexes were 38.3 ± 30.6 and 51.9 ± 28.3 events/hr for NREM and REM sleep, respectively. No differences were detected in obstructive respiratory event duration or degree of desaturation between REM and NREM sleep. Additionally, no difference in blood pressure (systolic and diastolic) was detected between REM and NREM sleep during obstructive events and post-obstructive event period. Simple linear regression identified history of hypertension as a predictor of increased systolic blood pressure during obstructive events and post-obstructive event period in both rapid eye movement and non-rapid eye movement sleep. Oxygen desaturation index was also a predictor of increased systolic blood pressure during obstructive events and post-obstructive event period in REM sleep. When obstructive event duration and the degree of desaturation were comparable, no difference in blood pressure was found between REM and NREM sleep during obstructive events and post-obstructive event period.
快速眼动期（REM）为主的阻塞性睡眠呼吸暂停已被证明与高血压独立相关。本研究旨在非侵入性地测量 REM 和非快速眼动期（NREM）阻塞事件以及阻塞后事件期间的血压。32 例连续的初次接受持续气道正压通气（CPAP）治疗的阻塞性睡眠呼吸暂停患者（男性占 50%），年龄 50.2±12 岁，接受了一整晚的多导睡眠图检查。血压通过一种基于脉搏传导时间和脉搏波速度的经过验证的方法间接评估，该方法用于测量 NREM 和 REM 阻塞事件（包括呼吸暂停和低通气）期间和阻塞后事件期间的血压。在招募的患者中，有 10 例（31.3%）患有高血压。平均呼吸暂停低通气指数为 40.1±27.6 次/小时。NREM 和 REM 睡眠时的呼吸暂停低通气指数分别为 38.3±30.6 和 51.9±28.3 次/小时。REM 和 NREM 睡眠时的呼吸暂停时间或低氧饱和度程度无差异。此外，在 REM 和 NREM 睡眠期间，阻塞事件和阻塞后事件期间，血压（收缩压和舒张压）无差异。简单线性回归发现，高血压病史是 REM 和 NREM 睡眠期间阻塞事件和阻塞后事件期间收缩压升高的预测因素。在 REM 睡眠期间，氧饱和度降低指数也是阻塞事件和阻塞后事件期间收缩压升高的预测因素。当阻塞事件持续时间和低氧饱和度程度相同时，在 REM 和 NREM 睡眠期间，阻塞事件和阻塞后事件期间的血压无差异。
