Characterization Of Sleep Structure And Hypoxic Parameters In Patients With Obstructive Sleep Apnea Combined With Hypertension

Objective:By analysing the characteristics of general data,sleep structure and hypoxic parameters in patients with obstructive sleep apnea(OSA)combined with hypertension at different ages,we explore the possible potential independent risk factors for patients with OSA combined with hypertension.The aim is to provide an in-depth understanding of the diagnostic and predictive role of Polysomnography(PSG)monitoring results in patients with OSA combined with hypertension,to provide a basis for early prevention and diagnosis of the disease,and to reduce the economic burden of the disease on patients and society.Methods:The data of 258 patients with OSA admitted to Jining NO.1 People’s Hospital from December 2021 to December 2022 were analyzed retrospectively,including apnea hypoventilation index(AHI),total sleep time(TST),unstable sleep time(UST),percentage of unstable sleep time(UST%),rapid eye movement sleep(REM),percentage of REM(REM%),lowed arterial oxygen saturation(LSaO2),mean oxygen saturation(MSpO2),time below 90%oxygen saturation(T90),percentage of time below 90%oxygen saturation(T90%),time below 90%oxygen saturation during REM(REM-T90),percentage of time below 90%oxygen saturation during REM(REM-T90%),and oxygen desaturation index(ODI).According to the results of blood pressure monitoring,the patients were divided into OSA with hypertension group and with OSA without hypertension group.The patients in both groups were further divided into youth group(<45 years)and middle-aged and elderly group(≥45 years)according to their age,the independent risk factors of hypertension in OSA in different age groups were found by regression analysis,and ROC curves were drawn to analyze the diagnostic value of each index.Results:1.A total of 258 subjects were included in this study,including 103(39.9%)in the OSA with hypertension group and 155(60.1%)in the OSA without hypertension group.2.The Age,BMI and smoking history of OSA with hypertension group were higher than those of OSA without hypertension group(p<0.05).There was no significant difference in sex and drinking history between the two groups(P>0.05).3.PSG parameters in OSA with hypertension group and OSA without hypertension group:AHI,Ust%and ODI in OSA with hypertension group were higher than those in OSA without hypertension group(p<0.05).There were no significant differences in TST,UST,REM,REM%,T90,T90%,MSPO2,LSaO2,REM-T90,REM-T90%between the two groups(P>0.05).4.Univariate analysis and multivariate analysis:BMI,age,smoking history,AHI Ust%,ODI were the risk factors of hypertension in OSA patients,the difference was statistically significant(p<0.05).Multivariate analysis showed that BMI,age and ODI were independent risk factors for hypertension in OSA(p<0.05).The regression equation was Y=-6.754+0.095 × BMI+0.062 × age+0.017 × ODI.5.The prevalence rate of OSA with hypertension in the young group was significantly higher than that in the middle-aged and elderly group(p<0.05).6.Analysis of the clinical data in the youth group:(1)There were significant differences in age,BMI,TST and ODI between OSA with hypertension and OSA without hypertension in the youth group(p<0.05);There were no significant differences in sex,smoking history,drinking history,AHI,UST,UST%,REM,REM%,T90,T90%,REM-T90,REM-T90%,MSPO2,LSaO2 between the two groups(P>0.05).(2)ODI is an independent risk factor for OSA with hypertension,and TST is a protective factor.According to the results of binary logistic regression analysis,the regression equation of the model was y=0.638+0.023 ×ODI+(-0.007 × TST).(3)using ODI to draw ROC curve,we know that the maximum area under the curve is 0.647(95%CI,0.545-0.750),the P value is 0.007,the maximum Youden index is 0.281,and the optimal threshold is 56.7 times/h,the sensitivity was 53.7%and the specificity was 74.4%.7.Analysis of the clinical data in the middle-aged and elderly group:(1)The BMI,AHI,UST%,T90,T90%,REM-T90,ODI of patients in OSA with hypertension group were higher than those in OSA without hypertension group(p<0.05).There was no significant difference in age,sex,smoking,drinking,TST,UST,REM,REM%,REM-T90%,MSpO2 and LSaO2 between the two groups(P>0.05).(2)T90 was an independent risk factor of hypertension in OSA in middle-aged and elderly patients.(3)the maximum area under the curve was 0.640(95%CI,0.544-0.736),the P value was 0.006,the maximum Youden index was 0.268,the optimal threshold was 61.25 min,the sensitivity was 46.8%,the specificity was 80.0%.Conclusion:1.In all the information,age,BMI,smoking history,AHI,UST%and ODI of OSA with hypertension group were higher than OSA without hypertension group,where age,BMI and ODI were the independent risk factors of hypertension in OSA.2.In patients with OSA,the prevalence of hypertension in middle-aged and elderly patients was higher than that in young patients.3.In the youth group,ODI is an independent risk factor of hypertension in OSA.When ODI>56.7 times/h,the risk of hypertension is higher.4.In the middle-aged and elderly group,T90 is an independent risk factor for hypertension in OSA.When T90>61.25 min,the risk of developing hypertension is higher.