Pak Victoria M, Butts Brittany, Hertzberg Vicki, Collop Nancy, Quyyumi Arshed A, Cox John, Rogers Ann, Dunbar Sandra B
Emory Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA.
Emory School of Medicine, Atlanta, GA, USA.
ERJ Open Res. 2020 Oct 26;6(4). doi: 10.1183/23120541.00310-2019. eCollection 2020 Oct.
Sleepiness in obstructive sleep apnoea is associated with cardiovascular risk; however, the biological mechanisms are not known. This study explored whether those with subjective sleepiness have increased plasma tumour necrosis factor-related protein 1 (C1qTNF1), a novel adipose-derived hormone (adipokine), and 24-h ambulatory blood pressure (ABP) compared to those without sleepiness in newly diagnosed, treatment-naïve participants with obstructive sleep apnoea.
Overall, 94 participants were included in the analysis. Participants completed the Epworth Sleepiness Scale (ESS), 24-h ABP was monitored, and plasma C1qTNF1 was measured. Sleepy participants were defined as ESS≥10 and nonsleepy as ESS<10. Multiple linear regression was used to explore differences in C1qTNF1, and 24-h mean arterial pressure (MAP) between sleepy and nonsleepy participants, adjusting for age, sex, body mass index, apnoea-hypopnoea index, and smoking status.
C1qTNF1 was significantly higher in sleepy participants (n=57) compared to nonsleepy participants (n=37) (β=0.41 NPX, 95% CI 0.02, 0.80; p=0.04). The 24-h MAP was significantly higher in sleepy participants compared to nonsleepy participants (β=4.06 mmHg, 95% CI 0.36, 7.77; p=0.03).
Our findings show that sleepiness is associated with inflammation and higher 24-h MAP in sleep apnoea.
阻塞性睡眠呼吸暂停中的嗜睡与心血管风险相关；然而，其生物学机制尚不清楚。本研究探讨了在新诊断的、未接受过治疗的阻塞性睡眠呼吸暂停参与者中，与无嗜睡者相比，主观嗜睡者的血浆肿瘤坏死因子相关蛋白1（C1qTNF1，一种新型脂肪源性激素（脂肪因子））及24小时动态血压（ABP）是否升高。
总共94名参与者纳入分析。参与者完成爱泼华嗜睡量表（ESS），监测24小时ABP，并测量血浆C1qTNF1。嗜睡参与者定义为ESS≥10，非嗜睡者为ESS<10。采用多元线性回归探讨嗜睡与非嗜睡参与者之间C1qTNF1及24小时平均动脉压（MAP）的差异，并对年龄、性别、体重指数、呼吸暂停低通气指数及吸烟状况进行校正。
与非嗜睡参与者（n = 37）相比，嗜睡参与者（n = 57）的C1qTNF1显著更高（β = 0.41 NPX，95%CI 0.02，0.80；p = 0.04）。与非嗜睡参与者相比，嗜睡参与者的2小时MAP显著更高（β = 4.06 mmHg，95%CI 0.36，7.77；p = 0.03）。
我们的研究结果表明，嗜睡与睡眠呼吸暂停中的炎症及更高的24小时MAP相关。
