绝经后女性阻塞性睡眠呼吸暂停低通气综合征患者慢波睡眠与清晨血压的关系

Relationship between slow wave sleep and morning blood pressure in postmenopausal women with obstructive sleep apnea hypopnea syndrome

目的研究绝经后阻塞性睡眠呼吸暂停低通气综合征(OSAHS)女性患者睡眠参数与清晨血压的关系。方法选取山西省心血管病医院2019年1月至2021年1月收治的40例经多导睡眠监测(PSG)诊断为OSAHS的绝经后女性,根据有无合并清晨高血压分为合并清晨高血压组(OH组、22例)和非高血压组(O组、18例),比较2组睡眠呼吸参数及清晨血压,并进行相关性分析。结果(1)2组研究对象年龄、体质量指数(BMI)、吸烟、饮酒情况差异无统计学意义(P>0.05)。(2)2组研究对象清晨血压及睡眠相关参数比较:与O组比较,呼吸暂停低通气指数(AHI)、3%氧减指数、微觉醒指数在OH组中明显升高(P<0.05);OH组中慢波睡眠比例明显低于O组(P<0.05);而最低血氧饱和度(LSpO_(2))、夜间血氧<90%的时间占睡眠时间的百分比、总睡眠时间、快速动眼睡眠比例、非快速动眼睡眠Ⅰ期比例、非快速动眼睡眠Ⅱ期比例在2组间差异无统计学意义(P>0.05)。(3)进行多因素Logistic回归分析显示:AHI、慢波睡眠比例是绝经后OSAHS女性患者发生清晨高血压的重要危险因素。结论OSAHS合并清晨高血压患者的AHI、3%氧减指数、微觉醒指数、慢波睡眠比例与单纯OSAHS患者的差异具有统计学意义,与清晨血压变化密切相关,且AHI、慢波睡眠比例是OSAHS伴清晨高血压患者的高危因素。

Objective To determine the relationship between sleep parameters and early morning blood pressure in postmenopausal women with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Forty postmenopausal women with OSAHS diagnosed by polysomnography(PSG)in Shanxi Provincial Cardiovascular Hospital between January 2019 and January 2021 were included in the study.According to the presence or ab-sence of early morning hypertension,the patients were divided into the OSAHS+morning hypertension group(OH group,n=22)and OSAHS group(O group,n=18).The sleep and breathing parameters,and early morning blood pressure were compared between the two groups and subjected to correlation analysis.Results There were no statistically significant differences in age,BMI,smoking and alcohol use between the two groups(all P>0.05).The early morning blood pressure and sleep related parameters were compared between the two groups.Compared with O group,the apnea hypopnea index(AHI),3%oxygen desaturation index and micro-arousal(ARL)index significantly increased in OH group(all P<0.05).The proportion of slow wave sleep in OH group was significantly lower than that in O group(P<0.05).There were no statistically significant differences in the lowest blood oxygen satura-tion(LSpO_(2)),TS90%,total sleep time,proportions of rapid eye movement(REM)sleep,stages I and II non-REM sleep between groups(all P>0.05).Multivariate logistic regression showed that AHI and the proportion of slow wave sleep were important risk factors for early morning hypertension in postmenopausal women with OS AHS.Conclusion AHI,3%oxygen desaturation index,micro-ARL index,and proportion of slow wave sleep signifi-cantly differs between OSAHS patients with and without early morning hypertension,and are closely related to the changes in morning blood pressure.AHI and proportion of slow wave sleep are high risk factors for OSAHS with early morning hypertension.