睡眠呼吸紊乱会增加糖尿病患者的死亡率。

Sleep-disordered breathing increases mortality in patients with diabetes.

作者信息

Vichova Teodora, Petras Marek, Waldauf Petr, Westlake Katerina, Vimmerova-Lattova Zuzana, Polak Jan

机构信息

Department of Pathophysiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

Department of Cardiology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.

出版信息

J Clin Sleep Med. 2025 Jan 1;21(1):89-99. doi: 10.5664/jcsm.11320.

DOI:10.5664/jcsm.11320

PMID:39206667

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11701274/

Abstract

STUDY OBJECTIVES

Sleep-disordered breathing and diabetes mellitus (DM) are often concomitant; however, data on the impact of sleep-disordered breathing on mortality in the population with diabetes remain scarce.

METHODS

The population from the Sleep Heart Health Study, a multicenter prospective observational study representing 5,780 patients with polysomnography and mortality data, including 453 patients with DM, was analyzed to assess the impact of sleep-disordered breathing variables and the presence of DM on all-cause, cardiovascular disease, and noncardiovascular disease associated mortality. Survival analysis and proportional hazard regression models were used to calculate the adjusted hazard ratios (aHRs) for mortality.

RESULTS

Patients with DM and the average oxygen saturation > 91.4% had significantly lower all-cause (aHR 0.52, confidence interval [CI] 0.34-0.80) and cardiovascular disease mortality risk (aHR 0.44, CI 0.22-0.87) as compared with patients with oxygen saturation below this value. Apnea-hypopnea index > 31 (aHR 1.58, CI 1.10-2.28) and oxygen desaturation index > 13.3 (aHR 1.58, CI 1.10-2.25) were associated with increased all-cause mortality in participants with DM on treatment. Sleep efficiency and proportion of rapid eye movement sleep did not have any impact on mortality in patients with DM and thus differed significantly from individuals without DM, where increased all-cause mortality was observed in those with sleep efficiency < 81.4% (aHR 0.77, CI 0.68-0.87) or rapid eye movement sleep < 14.9% (aHR 0.78, CI 0.68-0.89).

CONCLUSIONS

Patients with diabetes on treatment and moderate to severe sleep-disordered breathing experience increased all-cause mortality. Reduced average oxygen saturation predicted both all-cause and cardiovascular death in the population with diabetes.

CITATION

Vichova T, Petras M, Waldauf P, Westlake K, Vimmerova-Lattova Z, Polak J. Sleep-disordered breathing increases mortality in patients with diabetes. . 2025;21(1):89-99.

摘要

研究目的

睡眠呼吸障碍与糖尿病（DM）常同时存在；然而，关于睡眠呼吸障碍对糖尿病患者群体死亡率影响的数据仍然匮乏。

方法

对睡眠心脏健康研究中的人群进行分析，该研究是一项多中心前瞻性观察性研究，纳入了5780例有多导睡眠图和死亡率数据的患者，其中包括453例糖尿病患者，以评估睡眠呼吸障碍变量和糖尿病的存在对全因、心血管疾病以及非心血管疾病相关死亡率的影响。采用生存分析和比例风险回归模型计算死亡率的调整风险比（aHRs）。

结果

与平均血氧饱和度低于该值的患者相比，平均血氧饱和度>91.4%的糖尿病患者全因死亡率（aHR 0.52，置信区间[CI] 0.34 - 0.80）和心血管疾病死亡率风险（aHR 0.44，CI 0.22 - 0.87）显著更低。在接受治疗的糖尿病参与者中，呼吸暂停低通气指数>31（aHR 1.58，CI 1.10 - 2.28）和氧减饱和度指数>13.3（aHR 1.58，CI 1.10 - 2.25）与全因死亡率增加相关。睡眠效率和快速眼动睡眠比例对糖尿病患者的死亡率没有任何影响，因此与非糖尿病个体有显著差异，在非糖尿病个体中，睡眠效率<81.4%（aHR 0.77，CI 0.68 - 0.87）或快速眼动睡眠<14.9%（aHR 0.78，CI 0.68 - 0.89）的个体全因死亡率增加。

结论

接受治疗的糖尿病患者以及中重度睡眠呼吸障碍患者全因死亡率增加。平均血氧饱和度降低预示着糖尿病患者群体的全因死亡和心血管死亡。

引用文献

Vichova T, Petras M, Waldauf P, Westlake K, Vimmerova-Lattova Z, Polak J. Sleep-disordered breathing increases mortality in patients with diabetes.. 2025;21(1):89 - 99.