Lundetræ Ragnhild S, Lehmann Sverre, Saxvig Ingvild W, Saeed Sahrai, Gislason Thorarinn, Bjorvatn Bjørn
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
Sleep Med. 2025 Jul;131:106529. doi: 10.1016/j.sleep.2025.106529. Epub 2025 Apr 19.
To explore the association between obstructive sleep apnea (OSA) severity and C-reactive protein (CRP) levels in a large sample of patients. In addition, we investigated whether any such association between OSA and CRP could be explained by e.g., sleep duration, obesity, comorbid insomnia (COMISA), and chronic obstructive pulmonary disease (COPD).
The sample comprised 2404 patients referred to a university hospital with suspected OSA (mean age 49.6 ± 14.0 years, 68.7 % males). All patients underwent standard out-of-centre respiratory polygraphy and completed a comprehensive questionnaire prior to the sleep study, including Bergen Insomnia Scale and self-reported sleep duration. OSA was defined as a respiratory event index ≥5. Blood samples were collected and analyzed for CRP. Pearson chi-square tests explored differences between three CRP groups (<1 mg/L; 1-3 mg/L; >3 mg/L). Logistic regression analyses with CRP >3 mg/L as dependent variable were conducted with adjustment for OSA severity, mean oxygen saturation in peripheral blood (SpO), sex, age, body mass index, and significant predictors in the crude analyses.
Severe OSA was an independent predictor of CRP >3 mg/L (adjusted OR = 1.70, 95 % CI 1.18-2.44). Among patients with OSA, obesity, COMISA, and COPD were associated with CRP >3 mg/L (adjusted OR = 3.64 (2.06-6.41), 1.44 (1.07-1.95), and 2.53 (1.34-4.75), respectively), compared to no such comorbidity. The association between OSA and CRP was not explained by sleep duration as neither short (<6 h) nor long (≥9 h) sleep duration were significant predictors of CRP >3 mg/L among patients with OSA.
This study showed that severe OSA, obesity, COMISA, and COPD were significant predictors of CRP >3 mg/L in a large sample of patients with OSA.
在大量患者样本中探讨阻塞性睡眠呼吸暂停（OSA）严重程度与C反应蛋白（CRP）水平之间的关联。此外，我们调查了OSA与CRP之间的任何此类关联是否可以由例如睡眠时间、肥胖、共病失眠（COMISA）和慢性阻塞性肺疾病（COPD）来解释。
样本包括2404名因疑似OSA转诊至大学医院的患者（平均年龄49.6±14.0岁，68.7%为男性）。所有患者均接受标准的院外呼吸多导睡眠监测，并在睡眠研究前完成一份综合问卷，包括卑尔根失眠量表和自我报告的睡眠时间。OSA定义为呼吸事件指数≥5。采集血样并分析CRP。Pearson卡方检验探讨了三个CRP组（<1mg/L；1-3mg/L；>3mg/L）之间的差异。以CRP>3mg/L为因变量进行逻辑回归分析，并对OSA严重程度、外周血平均血氧饱和度（SpO）、性别、年龄、体重指数以及粗分析中的显著预测因素进行校正。
重度OSA是CRP>3mg/L的独立预测因素（校正OR=1.70，95%CI 1.18-2.44）。在OSA患者中，与无此类合并症相比，肥胖、COMISA和COPD与CRP>3mg/L相关（校正OR分别为3.64（2.06-6.41）、1.44（1.07-1.95）和2.53（1.34-4.75））。OSA与CRP之间的关联不能由睡眠时间来解释，因为在OSA患者中，短睡眠（<6小时）和长睡眠（≥9小时）均不是CRP>3mg/L的显著预测因素。
本研究表明，在大量OSA患者样本中，重度OSA、肥胖、COMISA和COPD是CRP>3mg/L的显著预测因素。
