폐쇄성 수면무호흡증 환자에서 신체적 특성이 수면 장애와 심혈관계합병증 발병에 미치는 영향: 예비연구
The Effect of Physical Characteristics on Sleep Disturbance and Cardiovascular Complications in Obstructive Sleep Apnea Patients: The Preliminary Study
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Background and Objectives Obstructive sleep apnea (OSA) is a common yet an under-diagnosed sleep related breathing disorder associated with many adverse health outcomes. OSA is commonly associated with cardiovascular disorders that include coronary artery disease, heart failure, hypertension, cardiac arrhythmias and stroke. The aim of this study was to investigate the physical characteristics of OSA patients as a screening test for sleep apnea associated cardiovascular disease. Subjects and Method One hundred twenty-six adult OSA patients were enrolled in this study. All subjects underwent an overnight polysomnography (PSG) and were determined body mass index (BMI), neck circumstance, waist circumstance, tonsil size, etc. Cardiovascular events, such as hypertension, cardiovascular accident, myocardial infarction, and angina were analyzed. The correlation and multiple regression analysis were conducted to find influential and predictive factors of cardiovascular complications of OSA. Results PSG findings, apnea-hypopnea index (AHI), minimal oxygen saturation, and oxygen desaturation index were associated with BMI, neck circumstance, and waist circumstance. Tonsil size was also associated with AHI and oxygen desaturation index. However, PSG results were not associated with cardiovascular accidents of OSA patients. Hypertension was associated with tonsil size, angina was associated with Mallampati score and cardiovascular accident was associated with tonsil size. Conclusion Although we cannot find the statistical relation between PSG results and cardiovascular disease, tonsil size and Mallampati score influenced the risk of cardiovascular accident.
Abstract
Background and Objectives Obstructive sleep apnea (OSA) is a common yet an under-diagnosed sleep related breathing disorder associated with many adverse health outcomes. OSA is commonly associated with cardiovascular disorders that include coronary artery disease, heart failure, hypertension, cardiac arrhythmias and stroke. The aim of this study was to investigate the physical characteristics of OSA patients as a screening test for sleep apnea associated cardiovascular disease. Subjects and Method One hundred twenty-six adult OSA patients were enrolled in this study. All subjects underwent an overnight polysomnography (PSG) and were determined body mass index (BMI), neck circumstance, waist circumstance, tonsil size, etc. Cardiovascular events, such as hypertension, cardiovascular accident, myocardial infarction, and angina were analyzed. The correlation and multiple regression analysis were conducted to find influential and predictive factors of cardiovascular complications of OSA. Results PSG findings, apnea-hypopnea index (AHI), minimal oxygen saturation, and oxygen desaturation index were associated with BMI, neck circumstance, and waist circumstance. Tonsil size was also associated with AHI and oxygen desaturation index. However, PSG results were not associated with cardiovascular accidents of OSA patients. Hypertension was associated with tonsil size, angina was associated with Mallampati score and cardiovascular accident was associated with tonsil size. Conclusion Although we cannot find the statistical relation between PSG results and cardiovascular disease, tonsil size and Mallampati score influenced the risk of cardiovascular accident.
참고문헌 (20)
- Bresnitz EA, "Epidemiology of obstructive sleep apnea", Epidemiol Rev, 16(2), pp.210~227 (1994)
- 홍석민, "폐쇄성 수면 무호흡증 환자에서 수술적 치료가혈장 Leptin 농도에 미치는 영향", 대한이비인후과학회지 두경부외과학, 49(8), pp.791~794 (2006), 대한이비인후과학회
- Kim J, "Prevalence of sleep-disordered breathing in middle-aged Korean men and women", Am J Respir Crit Care Med, 170(10), pp.1108~1113 (2004)
- McNicholas WT, "Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities", Eur Respir J, 29(1), pp.156~178 (2007)
- Marin JM, "Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study", Lancet, 365(9464), pp.1046~1053 (2005)
- Brodsky L, "Modern assessment of tonsils and adenoids", Pediatr Clin North Am, 36(6), pp.1551~1569 (1989)
- Somers VK, "Sleep apnea and cardiovascular disease: an American Heart Association", american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health), 2008, pp.118(10), 1080~1111
- Savransky V, "Chronic intermittent hypoxia induces atherosclerosis", Am J Respir Crit Care Med, 175(12), pp.1290~1297 (2007)
- 이종철, "수면시 자세 변화가 수면 무호흡 중증도에 미치는 영향:체질량 지수, 인두의 구조적 특성에 따른 비교", 대한이비인후과학회지 두경부외과학, 48(9), pp.1115~1121 (2005), 대한이비인후과학회
- Drager LF, "Additive effects of obstructive sleep apnea and hypertension on early markers of carotid atherosclerosis", Hypertension, 53(1), pp.64~69 (2009)
- Somers VK, "Sympathetic neural mechanisms in obstructive sleep apnea", J Clin Invest, 96(4), pp.1897~1904 (1995)
- Xie A, "Exposure to hypoxia produces long-lasting sympathetic activation in humans", J Appl Physiol, 91(4), pp.1555~1562 (2001)
- Parra O, "Sleep-related breathing disorders: impact on mortality of cerebrovascular disease", Eur Respir J, 24(2), pp.267~272 (2004)
- Quan SF, "Association of physical activity with sleep-disordered breathing", Sleep Breath, 11(3), pp.149~157 (2007)
- Jelic S, "Inflammation, oxidative stress, and repair capacity of the vascular endothelium in obstructive sleep apnea", Circulation, 117(17), pp.2270~2278 (2008)
- Davies RJ, "The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome", Eur Respir J, 3(5), pp.509~514 (1990)
- Vgontzas AN, "Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance?", Arch Physiol Biochem, 114(4), pp.211~223 (2008)
- Yaggi H, "Obstructive sleep apnoea and stroke", Lancet Neurol, 3(6), pp.333~342 (2004)
- Munoz R, "Severe sleep apnea and risk of ischemic stroke in the elderly", Stroke, 37(9), pp.2317~2321 (2006)
- Peppard PE, "Prospective study of the association between sleep-disordered breathing and hypertension", N Engl J Med, 342(19), pp.1378~1384 (2000)
