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学科主题: 临床医学
题名:
The Association between the Phenotype of Excessive Daytime Sleepiness and Blood Pressure in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome
作者: Wang, Qimin; Zhang, Cheng; Jia, Peng; Zhang, Jing; Feng, Liping; Wei, Shumin; Luo, Yiping; Su, Li; Zhao, Can; Dong, Hui; Ma, Jing; Wang, Guangfa
关键词: Obstructive sleep apnea hypopnea syndrome (OSAHS) ; Epworth sleepiness scale (ESS) ; excessive daytime sleepiness (EDS) ; Blood pressure (BP) ; AHI ; Chinese adults
刊名: INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
发表日期: 2014
DOI: 10.7150/ijms.7487
卷: 11, 期:7, 页:713-720
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: POSITIVE AIRWAY PRESSURE ; PLASMA OREXIN-A ; CARDIOVASCULAR EVENTS ; NONSLEEPY PATIENTS ; CONTROLLED-TRIAL ; OLDER-ADULTS ; HYPERTENSION ; MORTALITY ; SNORERS ; SCALE
英文摘要:

Objective Investigate the clinical features and the blood pressure (BP) pattern of the phenotype of excessive daytime sleepiness (EDS) in OSAHS.

Methods A total of 508 Chinese adults with suspected OSAHS were referred to our sleep laboratory from October 2009 to May 2012. On the same night of polysomnography (PSG), the levels of blood pressure were measured before sleeping (bedtime BP) and immediately after waking up in the next morning (morning BP). EDS was recognized as Epworth Sleepiness Scale (ESS)>= 9. Subjects were classified into four groups based on the apnea-hypopnea index (AHI) from PSG as follows: control (simple snoring) group (control, n=104) with AHI<5; mild group (mild, n=89) with AHI >= 5 and <15; moderate group (moderate, n=70) with AHI >= 15 and<30; and severe group (severe, n=245) with AHI >= 30. The differences and correlations between BP and PSG parameters in EDS and non-EDS group of OSAHS patients were analyzed.

Results In all subjects, ESS was positively correlated with morning diastolic blood pressure (DBP), Mean arterial pressure (MAP) and bedtime DBP (r=0.144, 0.102 and 0.114, respectively, each P value<0.05). In OSAHS patients, ESS was only positively correlated with morning DBP (r=0.137, P<0.05). OSAHS patients with EDS phenotype were younger and were more likely to have the symptom of waking up feeling tired (36.1% vs. 23.2%, p=0.023), who had lower MSaO2, longer SIT90 (the ratio of time of SpO2 below 90% in total sleep time) and higher DBP (bedtime as well as morning). In patients with AHI >= 15, ESS was correlated positively with both bedtime and morning DBP after controlling the confounding effects of age, sex, BMI, AHI and nadir nocturnal oxygen saturation(r=0.126,0.143, respectively, both P values<0.05). And in OSAHS patients of EDS phenotype, the bedtime DBP, bedtime MAP, morning DBP, and morning MAP were 3 similar to 5 mm Hg higher than that in patients of non-EDS phenotype(P<0.05). In the moderate and severe OSAHS group, patients with EDS phenotype were younger and had a lower mean blood oxygen saturation (MSaO2), longer time of SpO2 below 90% and higher SIT90 than patients with non-EDS phenotype (P<0.05). In hypertensive OSAHS patients, patients with EDS were also younger and had higher micro-arousal index (MiI), as well as higher morning DBP, morning MAP and bedtime DBP than that in non-EDS group (P<0.05).

Conclusions EDS in OSAHS patients is a special phenotype, which was characterized by younger age, higher DBP and more severe hypoxic load. This feature is mainly manifested in moderate and severe OSAHS patients. It is very important to identify the phenotype of EDS in patients with OSAHS, who may meet more benefits from effective treatment of OSAHS by correcting the intermittent nocturnal hypoxia and sleep fragmentation.

语种: 英语
所属项目编号: 30900646
项目资助者: National Natural Science Foundation of China
WOS记录号: WOS:000344636200009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50168
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: Peking Univ, Hosp 1, Dept Resp & Crit Care Med, Beijing 100034, Peoples R China

Recommended Citation:
Wang, Qimin,Zhang, Cheng,Jia, Peng,et al. The Association between the Phenotype of Excessive Daytime Sleepiness and Blood Pressure in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome[J]. INTERNATIONAL JOURNAL OF MEDICAL SCIENCES,2014,11(7):713-720.
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