Wang Yi, Chen Xi Xi, Lu Fang Ying, Yan Ya Ru, Li Shi Qi, Zhang Liu, Lin Ying Ni, Li Qing Yun
Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
NPJ Prim Care Respir Med. 2025 Apr 28;35(1):26. doi: 10.1038/s41533-025-00429-7.
Obstructive sleep apnea (OSA) is a well-established risk factor for hypertension, with sleep duration being a modifiable factor influencing this risk. However, sleep misperception among OSA patients makes it unclear how subjective and objective sleep duration are associated with the prevalence and incidence of hypertension in this population. This study aims to examine these associations using data from the Sleep Heart Health Study cohort. Participants with OSA (apnea-hypopnea index ≥ 15 events/hour) were categorized based on objective sleep duration from polysomnography (PSGTST) and subjective sleep duration (morning-reported sleep time, AMTST; habitual sleep time, HABTST). Hypertension prevalence was assessed at baseline, while hypertension incidence was evaluated during a five-year follow-up. Multivariable logistic regression and Poisson log-link models were employed to explore the association between sleep duration and hypertension risk, with restricted cubic splines used to assess nonlinear trends. Among 2574 participants with OSA, 1263 had hypertension at baseline. Over 5.25 years, 376 of 1001 patients without baseline hypertension developed hypertension. Shorter PSGTST was linearly associated with higher hypertension prevalence (p = 0.009) and incidence (p = 0.024). HABTST showed a U-shaped relationship with hypertension prevalence, while AMTST was not significantly associated with either outcome. In patients with OSA, objective sleep duration is linearly and inversely associated with both the prevalence and incidence of hypertension, showing stronger and more consistent associations than subjective sleep duration measures. These findings highlight the value of incorporating objective sleep assessment in evaluating hypertension risk in this population.
阻塞性睡眠呼吸暂停（OSA）是高血压的一个公认危险因素，睡眠时间是影响这一风险的一个可改变因素。然而，OSA患者中存在睡眠感知错误，这使得主观和客观睡眠时间与该人群高血压患病率和发病率之间的关联尚不清楚。本研究旨在利用睡眠心脏健康研究队列的数据来检验这些关联。根据多导睡眠图的客观睡眠时间（PSGTST）和主观睡眠时间（早晨报告的睡眠时间，AMTST；习惯性睡眠时间，HABTST）对OSA患者（呼吸暂停低通气指数≥15次/小时）进行分类。在基线时评估高血压患病率，在五年随访期间评估高血压发病率。采用多变量逻辑回归和泊松对数链接模型来探讨睡眠时间与高血压风险之间的关联，并使用受限立方样条来评估非线性趋势。在2574名OSA参与者中，1263人在基线时患有高血压。在5.25年的时间里，1001名无基线高血压的患者中有376人患上了高血压。较短的PSGTST与较高的高血压患病率（p = 0.009）和发病率（p = 0.024）呈线性相关。HABTST与高血压患病率呈U形关系，而AMTST与这两个结果均无显著关联。在OSA患者中，客观睡眠时间与高血压的患病率和发病率均呈线性负相关，与主观睡眠时间测量相比，显示出更强、更一致的关联。这些发现突出了在评估该人群高血压风险时纳入客观睡眠评估的价值。
