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阻塞性睡眠呼吸暂停高血压患者的睡眠结构与维生素D:一项多导睡眠图研究。

Sleep architecture and vitamin D in hypertensives with obstructive sleep apnea: A polysomnographic study.

作者信息

Kanclerska Justyna, Wieckiewicz Mieszko, Nowacki Dorian, Szymanska-Chabowska Anna, Poreba Rafal, Mazur Grzegorz, Martynowicz Helena

机构信息

Department of Internal Medicine, Occupational Diseases, Hypertension, and Clinical Oncology, Wroclaw Medical University, Poland.

Department of Experimental Dentistry, Wroclaw Medical University, Poland.

出版信息

Dent Med Probl. 2024 Jan-Feb;61(1):43-52. doi: 10.17219/dmp/172243.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) and arterial hypertension (AH) are closely linked disorders with common pathophysiological features.

OBJECTIVES

The present study aimed to investigate the relationship between AH and OSA by examining sleep architecture, vitamin D concentration and electrolyte levels in patients with these coexisting conditions.

MATERIAL AND METHODS

A total of 133 patients suspected of having OSA were recruited for examination. The participants were divided into 2 groups: hypertensives (n = 52); and normotensives (n = 81). One full-night polysomnographic examinations were conducted, followed by the statistical analysis of the collected data.

RESULTS

Hypertensive individuals displayed increased apnea-hypopnea index (AHI), oxygen desaturation index (ODI), respiratory arousal index (RAI), and periodic limb movement index (PLMI) as compared to non-hypertensive individuals. Moreover, sleep efficiency (SE), the bruxism arousal index (BAI) and oxygen saturation (SpO2) level were decreased in the hypertensive group. In terms of biochemical parameters, hypertensive individuals exhibited a lower magnesium (Mg) level, and higher levels of C-reactive protein (CRP), uric acid (UA) and glucose. Notably, there were no statistical differences in vitamin D concentration between hypertensive and normotensive individuals.

CONCLUSIONS

The study explored the potential influence of calcium (Ca), Mg, vitamin D, and UA concentrations on the sleep architecture of patients with comorbid AH and OSA. The findings revealed several notable associations. Firstly, sleep fragmentation correlated with Ca level, suggesting a potential role for both Ca and vitamin D in sleep arousals. Secondly, a higher UA concentration was linked to a higher AHI and increased sleep fragmentation. Additionally, alterations in Mg concentration were observed among hypertensive individuals with OSA. However, further research is needed to fully comprehend the potential impact of these factors on the sleep architecture of hypertensive individuals with apnea.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)和动脉高血压(AH)是具有共同病理生理特征的密切相关疾病。

目的

本研究旨在通过检查这些共存疾病患者的睡眠结构、维生素D浓度和电解质水平,探讨AH与OSA之间的关系。

材料与方法

共招募133名疑似患有OSA的患者进行检查。参与者分为两组:高血压患者(n = 52);和血压正常者(n = 81)。进行了一次整夜多导睡眠图检查,随后对收集的数据进行统计分析。

结果

与非高血压个体相比,高血压个体的呼吸暂停低通气指数(AHI)、氧饱和度下降指数(ODI)、呼吸唤醒指数(RAI)和周期性肢体运动指数(PLMI)增加。此外,高血压组的睡眠效率(SE)、磨牙唤醒指数(BAI)和氧饱和度(SpO2)水平降低。在生化参数方面,高血压个体的镁(Mg)水平较低,而C反应蛋白(CRP)、尿酸(UA)和葡萄糖水平较高。值得注意的是,高血压和血压正常个体之间的维生素D浓度没有统计学差异。

结论

本研究探讨了钙(Ca)、Mg、维生素D和UA浓度对合并AH和OSA患者睡眠结构的潜在影响。研究结果揭示了几个显著的关联。首先,睡眠片段化与Ca水平相关,表明Ca和维生素D在睡眠唤醒中可能发挥作用。其次,较高的UA浓度与较高的AHI和增加的睡眠片段化有关。此外,在患有OSA的高血压个体中观察到Mg浓度的变化。然而,需要进一步研究以充分理解这些因素对患有呼吸暂停的高血压个体睡眠结构的潜在影响。

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