Analysis of the relationship between rapid-eye-movement sleep indexes and hypertension related to obstructive sleep apnea-hypopnea syndrome

KUANG Ai-ling; WU Kang; ZHANG Yi-tao; SU Xiao-fen; CHEN Ri-ken; GUO Hui-zhi; LIU Heng; ZHANG Nuo-fu

doi:10.19538/j.nk2017120113

Abstract：Objective To study the relationship between rapid-eye-movement(REM) sleep indexes and the development of hypertension in patients obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 181 patients with OSAHS who were diagnosed by whole night polysomnography (PSG) at our hospital from May 2015 to May 2016 were included in the study.These patients were divided into two groups according to whether they developed hypertension:74 cases in OSAHS group and 107 in hypertension group.Compare the following items:general information,medical history,ESS score,BMI,neck circumference,waist circumference,blood pressure at getting up and before going to bed and the PSG indexes.Binary Logistic regression was used to analyze all the factors conbuting to hypertension development in OSAHS patients.Results There were no significant difference between the two groups in gender,the history of smoking and drinking,neck circumference or the score of ESS(P＞0.05).Compared to the OSAHS group,the age,body mass index (BMI),waist circumference,mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDSP) were higher in the hypertension group(P＜0.05).No significant difference was found in total sleep time(TST),sleep efficiency,non-rapid eye movement(NREM) sleep time,the percentage of NREM sleep time in TST(NREM％),rapid eye movement(REM) sleep time or the percentage of REM sleep time in TST(REM％) (P＞0.05).Apnea hypopnea index (AHI),apnea hypopnea index in REM sleep (REM-AHI) and apnea hypopnea index in NREM sleep (NREM-AHI) in hypertension group were significantly higher than those in OSAHS group(P＜0.05),while the mean oxygen saturation (MSPO2),mean oxygen saturation in REM sleep (REM-MSPO2),mean oxygen saturation in NREM sleep (NREM-MSPO2),the percentage of TST with oxygen saturation below 90％ (T90％),the percentage of REM sleep time with oxygen saturation below 90％(REM-T90％),the percentage of NREM sleep time with oxygen saturation below 90％(NREM-T90％) and lowest oxygen saturation (LSPO2) in hypertension group were significantly lower than those in OSAHS group(P＜0.05).Two factors were identified to be associated with OSAHS in patients with hypertension through binary logistic regression model:age (OR 1.056,95％CI 1.025-1.088),and REM-T90％(OR 1.022,95％CI 1.009-1.034).Conclusion OSAHS patients with hypertension may be more severe in age,AHI and hypoxia than those without hypertension.Our study indicats that REM-T90％ is independently associated with the development of hypertension among OSAHS patients.