阻塞性睡眠呼吸暂停综合征合并高血压患者的睡眠监测分析

Analysis of polysomnography results in patients with obstructive sleep apnea syndrome accompanied hypertension

目的 :探讨阻塞性睡眠呼吸暂停综合征 (OSAS)患者的睡眠结构 ,呼吸暂停以及低氧血症等与合并高血压的关系。方法 :分析 30例OSAS合并高血压与 30例OSAS血压正常患者的睡眠监测结果和血压变化情况 ,以 10例单纯鼾症为对照。结果 :OSAS合并高血压组呼吸暂停指数 ,伴呼吸紊乱的微觉醒 ,血氧下降 <70 %的次数以及睡眠呼吸暂停时间占总睡眠时间的比例与OSAS血压正常组差异有显著性 (P <0 .0 1,P <0 .0 5 )。OSAS合并高血压组和血压正常组睡眠结构与单纯鼾症比较明显异常 ,但两组差异无显著性。结论

Objective:To explore the relation of obstructive sleep apnea and hypopnea (OSAH) and systemic hypertension.Method: The sleep structure, sleep apnea, hypoxia, degree of arousal were analyzed in OSAS patients with and without hypertension and 10 snoring patients as controls. Results: 1. OSAS patients with and without hypertension compared with snoring group and normal people, the sleep structure were significantly disturbed. The time percentages of awake and stage Ⅰsleep were significantly increased, stage Ⅱsleep were significantly decreased, in OSAS patients than those in snoring group (P<0.01). The stage Ⅲ-Ⅳ sleep and REM sleep had no significantly different in the three groups. But the stage Ⅲ-Ⅳ sleep and REM sleep were significantly decreased in OSAS patients than those in normal people. There were no significantly different about the sleep structure in the two OSAS groups. 2. There were more total microarousal, and the microarousal that was associated with both apnea and leg movement in OSAS patients with and without hypertension than those in snoring group (P<0.01). The number of microarousal that was associated with apnea, the apnea index, the time of oxygen desaturation <70%, and the percentage to total apnea hypopnea time over total sleep time were significantly increased in OSAS patients accompanied by hypertension than those in the normotensive OSAS patients (P<0.01, P<0.05). Conclusions: 1.The sleep structure disturbance may not contribute to the OSAS-induced hypertension. 2. The microarousal and hypoxia may contribute to the OSAS-induced hypertension.