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Rapid eye movement (REM)-related obstructive sleep apnea and hypertension: insights from the clinical spectrum of apnea-hypopnea index ratios across REM and non-REM sleep stages in a Chinese cohort
被引:0
|作者:
Wang, Yuxin
[1
]
Shi, Chuan
[1
]
Luo, Jinmei
[1
]
Huang, Rong
[1
]
Xiao, Yi
[1
]
机构:
[1] Chinese Acad Med Sci & Peking Union Med Coll, Dept Pulm & Crit Care Med, Peking Union Med Coll Hosp, 1 Shuaifuyuan, Beijing 100730, Peoples R China
关键词:
hypertension;
obstructive sleep apnea (OSA);
rapid eye movement (REM) sleep;
REM-OSA;
SYMPATHETIC-NERVE ACTIVITY;
BLOOD-PRESSURE;
ASSOCIATION;
ARCHITECTURE;
GUIDELINE;
RELEVANCE;
OSA;
D O I:
10.1111/jsr.14418
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
Previous studies have linked sleep-disordered breathing during rapid eye movement (REM) sleep to hypertension. However, no standardised definition of REM-related obstructive sleep apnea (REM-OSA) exists. This study aimed to evaluate whether the ratio of the apnea-hypopnea index (AHI) in REM to that in non-REM (NREM) (REM-AHI/NREM-AHI) accurately identifies patients with OSA comorbid with hypertension. We screened 1439 participants and included 790 patients with OSA. REM-OSA was defined as AHI >= 5 events/h, REM-AHI/NREM-AHI >= 2, and REM stage >= 30 min. Differences between REM-OSA and NREM-OSA groups, and among quartiles of REM-AHI/NREM-AHI, were assessed. The impact of REM-AHI/NREM-AHI on hypertension was assessed by logistic regression and restricted cubic spline analysis. Overall, patients with REM-OSA, as traditionally defined, had a lower hypertension prevalence, lower blood pressure, and milder OSA. Patients with REM-AHI/NREM-AHI <2 but a higher total AHI had a higher prevalence of hypertension. The highest REM-AHI/NREM-AHI quartile had the mildest OSA and the lowest hypertension prevalence. In subgroups restricted by total AHI or NREM-AHI, a similar trend existed, suggesting that total AHI appeared more influential on hypertension than the predominance of REM-AHI. Restricted cubic spline analysis certified a non-linear relationship between REM-AHI/NREM-AHI and total AHI, blood pressure and hypertension prevalence. Our research showed that patients with REM-OSA defined by REM-AHI/NREM-AHI >= 2 are not the subgroup with the highest hypertension prevalence within the entire OSA population. It is important to avoid focusing solely on the REM-AHI/NREM-AHI ratio and overlooking the overall severity of OSA, which could lead to missing groups that also have a high prevalence of hypertension.
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