Association of total sleep time and oxygen desaturation index with hypertension in patients with obstructive sleep apnea/hypopnea syndrome
10.3760/cma.j.cn114798-20231027-00330
- VernacularTitle:总睡眠时间和氧减指数与OSA合并高血压的关联分析
- Author:
Wenxu ZHOU
1
;
Jiaying LI
;
Chen ZHOU
;
Xiuqin MA
;
Taofeng ZHU
Author Information
1. 江苏大学附属宜兴医院全科医学科，宜兴 214200
- Keywords:
Sleep apnea, obstructive;
Hypertension;
Total sleep time;
Oxygen desaturation index
- From:
Chinese Journal of General Practitioners
2024;23(6):654-660
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association of total sleep time (TST) and oxygen desaturation index (ODI) with hypertension in patients with obstructive sleep apnea/hypopnea syndrome (OSA).Methods:A total of 440 OSA patients admitted to Yixing Hospital from January 2017 to December 2022 were consecutively enrolled, including 236 patients with hypertension (OSA+hypertension group) and 204 patients without hypertension (OSA group). The clinical data and polysomnograpic parameters were collected. Univariate and multivariate logistic regression was used to analyze the related factors of OSA complicated with hypertension. The multiplicative interaction between TST and ODI on OSA with hypertension was analyzed. A two-factor cross-over analysis of TST and ODI was performed and the additive interaction model was used to analyze the additive interaction between TST and ODI on OSA with hypertension.Results:Univariate logistic regression showed that male sex, smoking, diabetes, coronary heart disease, TST <7 h, age, body mass index, neck circumference, waist circumference, Epworth Sleepiness Scale (ESS) score, TST, AHI, ODI>16 times/h, triglyceride, high density lipoprotein cholesterol and fasting blood glucose were positively correlated with hypertension in OSA patients (all P<0.05). Multivariate logistic regression analysis showed that smoking ( OR=4.327, 95% CI: 2.499-2.499, P<0.001), TST<7 h ( OR=1.748, 95% CI: 1.079-2.832, P=0.023) and ODI>16 times/h ( OR=3.482, 95% CI: 2.016-6.014, P<0.001) were independently associated with hypertension in OSA patients. After introducing a multiplicative term and adjusting for confounding factors, there was a positive multiplication interaction between TST <7 h and ODI>16 times/h ( OR=2.958, 95% CI: 1.079-8.113, P<0.050). Multivariate logistic regression analysis showed that the risk of hypertension in OSA patients with TST<7 h and ODI>16 times/h was 7.196 times (95% CI: 3.421-15.137) higher than that in patients with TST≥7 h and ODI≤16 times/h. The additive interaction model showed a synergistic effect between TST<7 h and ODI>16 times/h, with S value of 4.302 (95% CI: 1.566-11.815), RERI value of 4.756 (95% CI: 0.642-8.869) and API value of 66.10% (95% CI: 43.10%-89.10%). Conclusion:Shortened sleep duration and increased ODI are independent risk factors for hypertension in OSA patients, and when they coexist, the risk of hypertension in OSA patients is further increased.
