Eur Respir J:合并失眠和阻塞性睡眠呼吸暂停增加47%的死亡风险

2021-12-12 小文子 MedSci原创

COMISA与基线时较高的高血压和心血管疾病发生率相关。

失眠患者和阻塞性睡眠呼吸暂停(OSA)患者的死亡率增加。然而,两种疾病通常同时发生,合并失眠和阻塞性睡眠呼吸暂停(COMISA)对死亡风险的影响尚不清楚。Eur Respir J杂志的一项研究使用睡眠与心脏健康研究项目(SHHS)数据评估COMISA与全因死亡风险之间的相关性。

将失眠定义为入睡困难,睡眠中断,清晨从睡眠中醒来≥16次/月及白天睡眠障碍。OSA定义为呼吸暂停低通气指数≥15次/h。如果同时存在两种情况,则定义为COMISA。主要结果为全因死亡,使用多变量校正Cox比例风险模型确定COMISA与15年随访期间全因死亡率(n = 1210)之间的相关性。

研究共纳入5236例参与者。2708例(52%)无失眠/OSA(对照),170例(3%)单纯失眠,2221例(42%)单纯OSA,137例(3%)COMISA。与对照组(1.70, [1.11,2.61])相比,COMISA参与者的高血压(ORs=2.00; 95%CI [1.39,2.90])和心血管疾病患病率更高。与对照组相比,单纯失眠和单纯OSA与较高的高血压风险相关,但与心血管疾病无关。COMISA患者的总睡眠时间比单纯OSA组少12分钟(-12.37[-23.2,-1.5],p=0.025),但与单纯失眠组相比,总睡眠时间无显著差异(-2.3[-16.6, 11.9],p=0.74)。中位随访时间11.8(10.4,15.9)年,死亡人数1210例。与对照组相比,COMISA与47%的死亡风险增加(HR=1.47; 95%CI [1.06,2.07])相关。在OSA和失眠的多种定义中,COMISA与死亡率之间的相关性一致。

结果表明,与无失眠/OSA相比,COMISA与基线时较高的高血压和心血管疾病发生率相关,并增加了全因死亡的风险。

原文出处:

Lechat B, Appleton S, Melaku YA, et al. Co-morbid insomnia and obstructive sleep apnoea is associated with all-cause mortality. Eur Respir J 2021, https://doi.org/10.1183/13993003.01958-2021.

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