睡眠呼吸暂停综合征患者血压结构、夜间睡眠结构的相关性

Correlation Between Blood Pressure Structure and Nighttime Sleep Structure in Patients with Sleep Apnea Syndrome

目的运用基于时辰的心肺耦合(cardiopulmonary coupling,CPC)睡眠监测技术探讨睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)患者血压结构及夜间睡眠结构的相关性。方法纳入因睡眠问题就诊的92例患者,采用基于时辰的CPC监测仪和24 h动态血压(ambulatory blood pressure monitoring,ABPM)监测仪,进行同步监测,采集相关数据。根据CPC计算的呼吸紊乱指数(respiratory disturbance index,RDI),将患者分为非SAS组23例,SAS组69例,分析两组间血压、夜间睡眠结构的差异;并比较不同程度SAS患者血压、夜间睡眠结构的差异;以及SAS患者RDI与夜间子、丑、寅时睡眠结构的相关性。结果①SAS组高血压患病率、异常血压节律发生率明显增高;且初入熟睡时间较长,熟睡时间减少,浅睡时间增多。②轻、中、重度SAS患者夜间睡眠结构差异有统计学意义(P<0.05)。③不同程度SAS患者与夜间子、丑、寅时睡眠结构存在部分差异,进一步线性回归分析发现,SAS患者RDI与子时、寅时浅睡眠时间呈正相关。结论SAS患者高血压患病率、异常血压节律发生率高,存在夜间睡眠结构紊乱;不同程度SAS患者间血压结构差异不明显,睡眠结构的主要差异在于不稳定睡眠增多,而稳定睡眠减少,且SAS严重程度与子、寅时浅睡时间呈正相关。

Objective To investigate the correlation between blood pressure structure and nighttime sleepstructure in patients with sleep apnea syndrome(SAS)by using Shichen-based cardiopulmonary coupling(CPC)sleep monitoring technique.Methods A total of 92 patients who attended the hospital due to sleep problems were enrolled,and a Shichen-based CPC monitor and a 24-hour ambulatory blood pressure monitor were used for synchronous monitoring and data collection.According to the respiratory disturbance index(RDI)calculated based on CPC,the patients were divided into non-SAS group with 23 patients and SAS group with 69 patients,and the two groups were compared in terms of blood pressure and nighttime sleep structure.Blood pressure and nighttime sleep structure were also compared between patients with different severities of SAS,and the correlation of RDI with nighttime sleep structure during the periods of the day from 11 p.m.to 1 a.m.,from 1 a.m.to 3 a.m.,and from 3 a.m.to 5 a.m.was analyzed in the patients with SAS.Results The SAS group had significant increases in the prevalence rate of hypertension and the incidence rate of abnormal blood pressure rhythm,with a longer initial sleep time,a shorter deep sleep time,and a longer light sleep time.There was asignificant difference in nighttime sleep structure between the mild,moderate,and severe SAS groups(P<0.05).There were certain differences in nighttime sleep structure during the periods of the day from 11 p.m.to 1 a.m.,from 1 a.m.to 3 a.m.,and from 3 a.m.to 5 a.m.between the patients with different severities of SAS,and further linear regression analysis showed that RDI was positively correlated with light sleep time during the periods of the day from 11 p.m.to 1 a.m and from 3 a.m.to 5 a.m.in the patents with SAS.Conclusion Patients with SAS tend to have a high prevalence rate of hypertension and a high incidence rate of abnormal blood pressure rhythm,with disturbance of nighttimesleep structure.There is no significant difference in blood pressure structure between patients with different severities of SAS.The main differences in sleep structure are the increase in unstable sleep and the reduction in stable sleep,and the severity of SAS is positively correlated with light sleep time during the periods of the day from 11 p.m.to 1 a.m and from 3 a.m.to 5 a.m.