Welcome to JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) June 23, 2025
| Citation: |
LI Xiaoying, ZHANG Chenxu, ZENG Ping, et al. Effect of Obstructive Sleep Apnea Syndrome on Nocturnal Ambulatory Blood Pressure Monitoring Results in Older Adults Without Cardiovascular or Cerebrovascular Diseases[J]. Journal of Sichuan University (Medical Sciences), 2025, 56(2): 464-469. DOI: 10.12182/20250360110
|
To investigate the effect of obstructive sleep apnea syndrome (OSAS) on nocturnal ambulatory blood pressure monitoring results in older adults without cardiovascular or cerebrovascular diseases, and to identify factors causing fluctuations in nocturnal blood pressure in older adults with OSAS.
A total of 169 older adult OSAS patients with no history of cardiovascular or cerebrovascular diseases were enrolled. According to their severity of OSAS, the participants were divided into 4 groups, including a normal OSAS group, a mild OSAS group, a moderate OSAS group, and a severe OSAS group. The baseline characteristics of the 4 groups were compared to identify differences. The relationship between polysomnography parameters and nocturnal ambulatory blood pressure monitoring results and the factors causing nocturnal blood pressure fluctuations in older adults with OSAS were further analyzed.
The nocturnal blood pressure fluctuation (NBPF) index of the normal OSAS group, the mild OSAS group, the moderate OSAS group, and the severe OSAS group were 1.89 ± 1.58, 3.35 ± 5.40, 3.90 ± 6.40, and 16.60 ± 27.70, respectively, indicating that the NBPF index gradually increased with the increasing severity of OSAS (P < 0.05). According to findings from the partial correlation analysis, the NBPF index was positively correlated with apnea-hypopnea index (AHI), micro-awakening index (MAI), percentage of cumulative time with oxygen saturation under 90% in the total sleep time (TS90%), oxygen desaturation index (ODI), and the longest apnea time (LAT) (P < 0.05), and negatively correlated with the lowest oxygen saturation (LSpO2) and sleep quality index (SQI) (P < 0.05). The mean nocturnal systolic and diastolic blood pressures were positively correlated with AHI, ODI, and TS90% (P < 0.05). A multi-factor regression analysis showed that every time ODI increased by 1 unit, the NBPF index increased by 0.26 units (β = 0.26; 95% CI, 0.03-0.50; P = 0.030), and every time TS90% increased by 1 unit, the NBPF index increased by 26.78 units (β = 26.78; 95% CI, 2.47-51.08; P = 0.031).
In older adult OSAS patients without cardiovascular or cerebrovascular disease, fluctuations in blood pressure at night become more pronounced with increasing disease severity. ODI and TS90% are important factors that affect nocturnal blood pressure fluctuations.
| [1] |
BENJAFIELD A, AYAS N, EASTWOOD P, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med, 2019, 7(8): 687-698. doi: 10.1016/S2213-2600(19)30198-5.
|
| [2] |
付卓志, 吴亚岑, 李媚希, 等. 阻塞性睡眠呼吸暂停严重度评估参数及诊断技术. 生物化学与生物物理进展, 2025, 52(1): 147-161. doi: 10.16476/j.pibb.2024.0214.
FU Z Z, WU Y C, LI M X, et al. Severity assessment parameters and diagnostic technologies of obstructive sleep apnea. Progress in Biochemistry and Biophysics, 2025, 52(1): 147-161. doi: 10.16476/j.pibb.2024.0214.
|
| [3] |
TANAKA N , OKADA M , TANAKA K , et al. Impact of continuous positive airway pressure for severe sleep apnea on very late recurrence in patients receiving catheter ablation of atrial fibrillation. Europace, 2024 (Supplement_1): Supplement_1. doi: 10.1093/europace/euae102.702.
|
| [4] |
杨海珍, 岳芳, 胡克. 老年及体弱老年人群睡眠呼吸障碍的治疗选择. 国际老年医学杂志, 2023, 44(3): 370-373. doi: 10.3969/j.issn.1674-7593.2023.03.026.
YANG H Z, YUE F, HU K. The Treatment options of sleep-disordered breathing in the elderly and frail elderly. International Journal of Geriatrics, 2023, 44(3): 370-373. doi: 10.3969/j.issn.1674-7593.2023.03.026.
|
| [5] |
ACHARYA R, BASNET S, THARU B, et al. Obstructive sleep apnea: risk factor for arrhythmias, conduction disorders, and cardiac arrest. Cureus, 2020, 12(8): e9992. doi: 10.7759/cureus.9992.
|
| [6] |
TORRES G, SÁNCHEZ-De-La-TORRE M, BARBÉ F. Relationship between OSA and hypertension. Chest, 2015, 148(3): 824-832. doi: 10.1378/chest.15-0136.
|
| [7] |
CARDOSO C, SALLES G F. Associations of the nocturnal blood pressure fall and morning surge with cardiovascular events and mortality in individuals with resistant hypertension. J Hypertens, 2021, 39(6): 1177-1187. doi: 10.1097/HJH.0000000000002775.
|
| [8] |
CREMER A, DOUBLET J, BOULESTREAU R, et al. Short-term blood pressure variability, arterial stiffness, and cardiovascular events: results from the Bordeaux cohort. J Hypertens, 2021, 39(5): 947-951. doi: 10.1097/HJH.0000000000002735.
|
| [9] |
舒兰, 卢雨, 李小英, 等. 阻塞性睡眠呼吸暂停患者夜间血压变化及影响因素研究. 现代预防医学, 2022, 49(24): 4529-4532. doi: 10.20043/j.cnki.MPM.202207293.
SHU L, LU Y, LI X Y, et al. Analysis of nocturnal blood pressure changes and influencing factors in patients with obstructive sleep apnea. Modern Preventive Medicine, 2022, 49(24): 4529-4532. doi: 10.20043/j.cnki.MPM.202207293.
|
| [10] |
赵力博, 刘霖, 李建华, 等. 老年阻塞性睡眠呼吸暂停低通气综合征相关高血压影响因素分析. 中华老年心脑血管病杂志, 2021, 23(4): 372-374. doi: 10.3969/j.issn.1009-0126.2021.04.010.
ZHAO L B, LIU L, LI J H, et al. Influencing factors of OSAHS-related hypertension in the elderly. Chin J Geriatr Heart Brain Vessel Dis, 2021, 23(4): 372-374. doi: 10.3969/j.issn.1009-0126.2021.04.010.
|
| [11] |
张炜, 刘晋星, 顾莹珍, 等. 老年中重度睡眠呼吸暂停综合征患者动态血压特征分析. 中国分子心脏病学杂志, 2023, 23(4): 5496-5501. doi: 10.16563/j.cnki.1671-6272.2023.08.005.
ZHANG W, LIU J X, GU Y Z, et al. Characteristics of ambulatory blood pressure in elderly patients with moderate to severe obstructive sleep apnea syndrome. Molecular Cardiology of China, 2023, 23(4): 5496-5501. doi: 10.16563/j.cnki.1671-6272.2023.08.005.
|
| [12] |
中国医师协会睡眠医学专业委员会, 中国医师协会神经内科医师分会睡眠学组. 中国成人失眠共病阻塞性睡眠呼吸暂停诊治指南(2024版). 中国全科医学, 2025, 28(11): 1289-1303. doi: 10.12114/j.issn.1007-9572.2024.0483.
Sleep Medicine Group, China Neurologist Association; Chinese Academy Society of Sleep Medicine, Chinese Medical Doctor Association. Chinese guideline for diagnosis and treatment of co-morbid insomnia and sleep apnea (2024). Chin Gen Prac, 2025, 28(11): 1289-1303. doi: 10.12114/j.issn.1007-9572.2024.0483.
|
| [13] |
中国高血压防治指南修订委员会, 高血压联盟(中国), 中国医疗保健国际交流促进会高血压病学分会, 等. 中国高血压防治指南(2024年修订版). 中华高血压杂志, 2024, 32(7): 603-700. doi: 10.16439/j.issn.1673-7245.2024.07.002.
China Hypertension Prevention and Treatment Guidelines Revision Committee, Hypertension Alliance (China), China Association for the Promotion of International Exchanges in Health Care Hypertension Branch, et al. Chinese guidelines for prevention and treatment of hypertension (2024 revision). Chin J Hypertens, 2024, 32(7): 603-700. doi: 10.16439/j.issn.1673-7245.2024.07.002.
|
| [14] |
郎晓荣, 黄素芳, 冯丹妮. 持续气道正压通气对于阻塞性睡眠呼吸暂停相关性高血压的治疗效果研究进展. 心脏杂志, 2023, 35(2): 233-236. doi: 10.12125/j.chj.202109081.
LANG X R, HUANG S F, FENG D N. Effect of continuous positive airway pressure on obstructive sleep apnea related hypertension. Chin Heart J, 2023, 35(2): 233-236. doi: 10.12125/j.chj.202109081.
|
| [15] |
ZHU Q, CHEN L, XU Q, et al. Association between obstructive sleep apnea and risk for post-stroke anxiety: a Chinese hospital-based study in noncardiogenic ischemic stroke patients. Sleep Med, 2023, 107: 55-63. doi: 10.1016/j.sleep.2023.04.016.
|
| [16] |
YEGHIAZARIANS Y, JNEID H, TIETJENS J R, et al. Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American heart association. Circulation, 2021, 144(3): e56-e67. doi: 10.1161/CIR.0000000000000988.
|
| [17] |
QIN H, STEENBERGEN N, GLOS M, et al. The different facets of heart rate variability in obstructive sleep apnea. Front Psychiatry, 2021, 12: 642333. doi: 10.3389/fpsyt.2021.642333.
|
| [18] |
KARIO K, HOSHIDE S, MIZUNO H, et al. Nighttime blood pressure phenotype and cardiovascular prognosis: practitioner-based nationwide JAMP study. Circulation, 2020, 142(19): 1810-1820. doi: 10.1161/circulationaha.120.049730.
|
| [19] |
WU Z H, TANG Y, NIU X, et al. The role of nitric oxide (NO) levels in patients with obstructive sleep apnea-hypopnea syndrome: a meta-analysis. Sleep Breath, 2021, 25(1): 9-16. doi: 10.1007/s11325-020-02095-0.
|
| [20] |
中国老年医学学会睡眠医学分会. 老年睡眠呼吸暂停综合征诊断评估专家共识. 中国全科医学, 2022, 25(11): 1283-1293. doi: 10.12114/j.issn.1007-9572.2022.0014.
Chinese Association of Geriatric Sleep Medicine, Chinese Geriatrics Societ. Chinese consensus on diagnosis and assessment of sleep apnea syndrome in older adults. Chin Gen Prac, 2022, 25(11): 1283-1293. doi: 10.12114/j.issn.1007-9572.2022.0014.
|
| [21] |
PEPPARD P E, YOUNG T, PALTA M, et al. Prospective study of the association between sleep disordered breathing and hypertension. N Engl J Med, 2000, 342(19): 1378-1384. doi: 10.1056/NEJM200005113421901.
|
| [22] |
YOON I Y, JEONG D U. Degree of arousal is most correlated with blood pressure reactivity during sleep in obstructive sleep apnea. J Korean Med Sci, 2002, 16(6): 707-711. doi: 10.3346/jkms.2001.16.6.707.
|
| [23] |
REN R, LI Y, ZHANG J, et al. Obstructive sleep apnea with objective daytime sleepiness is associated with hypertension. Hypertension, 2016, 68(5): 1264-1270. doi: 10.1161/HYPERTENSIONAHA.115.06941.
|
| [24] |
GOTTLIEB E, KHLIF M S, BIRD L, et al. Sleep architectural dysfunction and undiagnosed obstructive sleep apnea after chronic ischemic stroke. Sleep Med, 2021, 83(1): 45-53. doi: 10.1016/J.SLEEP.2021.04.011.
|
| [25] |
REN R, COVASSIN N, ZHANG Y, et al. Interaction between slow wave sleep and obstructive sleep apnea in prevalent hypertension. Hypertension, 2020, 75(2): 516-523. doi: 10.1161/HYPERTENSIONAHA.119.13720.
|
| [26] |
刘奕姝, 于悦, 谭慧文, 等. 阻塞性睡眠呼吸暂停低通气综合征与失眠共病患者的临床特点及相关因素分析. 中国医科大学学报, 2020, 49(3): 239-243. doi: 10.12007/j.issn.0258-4646.2020.03.010.
LIU Y S, YU Y, TAN H W, et al. Analysis of the clinical characteristics and relevant factors of comorbid obstructive sleep apnea hypopnea syndrome and insomnia. Journal of China Medical University, 2020, 49(3): 239-243. doi: 10.12007/j.issn.0258-4646.2020.03.010.
|
OPEN ACCESS This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (CC BY-NC 4.0). In other words, the full-text content of the journal is made freely available for third-party users to copy and redistribute in any medium or format, and to remix, transform, and build upon the content of the journal. You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may not use the content of the journal for commercial purposes. For more information about the license, visit https://creativecommons.org/licenses/by-nc/4.0
Official website of Journal of Sichuan University (Medical Sciences)
WeChat official account of Journal of Sichuan University(Medical Sciences)
WeChat subscription account of Journal of Sichuan University(Medical Sciences)
Home
DownLoad: