Lofaso F, Coste A, Gilain L, Harf A, Guilleminault C, Goldenberg F
Service de Physiologie-Explorations Fonctionnelles, Institut National de la Santé et de la Recherche Médicale Inserm, Créteil, France.
Chest. 1996 Apr;109(4):896-900. doi: 10.1378/chest.109.4.896.
Although a high prevalence of hypertension has been observed in snorers, whether there is a direct link between hypertension and snoring remains controversial. It has recently been demonstrated that an abnormal amount of breathing effort during snoring is responsible for sleep fragmentation even in the absence of sleep apnea syndrome criteria. We hypothesized that sleep fragmentation during snoring may be a direct risk factor for the development of hypertension. On the basis of polysomnographic data, 105 nonapneic patients between 40 and 65 years of age referred for snoring with social impairment were selected and categorized as snorers with (n=55) or without sleep fragmentation (n=50) based on whether the arousals index was 10 or greater or less than 10/h of sleep, respectively. Sleep distribution did not differ between the two groups, except for a longer duration of wake after sleep onset (58 +/- 43 min vs 42 +/- 38 min) and a shorter duration of slow-wave sleep in the group with sleep fragmentation (72 +/- 34 min vs 97 +/- 34 min). Although there were no statistically significant differences between the snorers with and without sleep disruption in terms of age (51.3 +/- 7.7 vs 48.6 +/- 6.0 years), body mass index (26.9 +/- 4.0 vs 27.2 +/- 5.5 kg/m2), sex ratio, respiratory indexes during sleep, daytime sleepiness, and daytime tiredness, prevalence of systemic hypertension was significantly higher in the sleep-fragmented group (20/55 vs 7/50). This significant difference persisted (16/51 vs 6/49) when patients using antihypertensive drugs with possible effects on the CNS were excluded. Our data suggest that sleep fragmentation is common in patients who seek medical help for snoring with social impairment and may play a role in the development of hypertension.
尽管在打鼾者中观察到高血压的高患病率，但高血压与打鼾之间是否存在直接联系仍存在争议。最近有研究表明，即使在没有睡眠呼吸暂停综合征标准的情况下，打鼾期间异常的呼吸努力也会导致睡眠碎片化。我们推测，打鼾期间的睡眠碎片化可能是高血压发生的直接危险因素。基于多导睡眠图数据，选择了105名40至65岁因打鼾伴社交障碍而就诊的非呼吸暂停患者，并根据觉醒指数是否为每小时睡眠10次或更多或少于10次，分别分为有睡眠碎片化的打鼾者（n = 55）或无睡眠碎片化的打鼾者（n = 50）。除了睡眠开始后觉醒时间较长（58±43分钟对42±38分钟）以及睡眠碎片化组中慢波睡眠时间较短（72±34分钟对97±34分钟）外，两组之间的睡眠分布没有差异。尽管有睡眠碎片化和无睡眠碎片化的打鼾者在年龄（51.3±7.7对48.6±6.0岁）、体重指数（26.9±4.0对27.2±5.5kg/m²）、性别比例、睡眠期间的呼吸指数、白天嗜睡和白天疲劳方面没有统计学上的显著差异，但睡眠碎片化组中系统性高血压的患病率显著更高（20/55对7/50）。当排除使用可能对中枢神经系统有影响的抗高血压药物的患者时，这种显著差异仍然存在（16/51对6/49）。我们的数据表明，睡眠碎片化在因打鼾伴社交障碍而寻求医疗帮助的患者中很常见，并且可能在高血压的发生中起作用。
