阻塞性睡眠呼吸暂停与昼夜静息-活动节律之间的关联：ELSA-Brasil队列的横断面分析
The Association Between Obstructive Sleep Apnea and the Circadian Rest-Activity Rhythm: A Cross-sectional Analysis of the ELSA-Brasil Cohort.
文献信息
| PMID | 42754505 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Adriano D S Targa |
| 作者单位 | Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain. Electronic address: atarga@irblleida.cat. |
| 期刊 | Archivos de bronconeumologia |
| SCI 分区 | Q1 |
| IF | 6.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 探讨阻塞性睡眠呼吸暂停（OSA）与昼夜静息-活动节律之间的潜在关联。
方法： 巴西成人健康纵向研究（ELSA-Brasil）中年龄35-74岁的在职或退休员工符合纳入条件。参与者接受了标准化临床评估，完成了睡眠问卷，进行了家庭睡眠呼吸暂停测试，并佩戴腕部活动监测器一周。用于表征昼夜静息-活动节律的主要变量是日内变异性（IV）、日间稳定性（IS）、相对振幅（RA）和昼夜功能指数（CFI）。
结果： 该队列包括1828名参与者（56.1%为女性），平均（标准差）年龄为49.1（8.2）岁。在调整潜在混杂因素后，OSA与任何昼夜相关变量均无显著关联。然而，分层分析显示，将呼吸暂停-低通气指数（AHI）作为连续变量处理时，较高的AHI仅在女性中与CFI降低相关，并且在年龄最大三分位组中与日间活动减少相关（-6.41 [-10.64至-2.17]）。最后，整合数据分析显示，以氧饱和度低于90%的时间百分比更高、总睡眠时间减少和日间嗜睡为特征的OSA表型与昼夜节律紊乱模式相关，表现为IV增加、RA降低和IS减弱。
结论： 这些发现表明，OSA与昼夜静息-活动节律之间的关联受患者特异性特征和疾病相关因素的影响，强调了在此背景下管理潜在昼夜节律紊乱时以患者为中心的方法的重要性。
英文摘要
OBJECTIVES: To investigate the potential association between obstructive sleep apnea (OSA) and the circadian rest-activity rhythm.
METHODS: Active or retired employees aged 35-74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were eligible for inclusion. Participants underwent a standardized clinical evaluation, completed sleep questionnaires, performed a home sleep apnea test, and wore a wrist activity monitor for one week. The primary variables used to characterize the circadian rest-activity rhythm were intradaily variability (IV), interdaily stability (IS), relative amplitude (RA), and the circadian function index (CFI).
RESULTS: The cohort comprised 1828 participants (56.1% female), with a mean (SD) age of 49.1 (8.2) years. After adjustment for potential confounders, OSA showed no significant associations with any circadian-related variables. However, stratified analyses revealed that higher apnea-hypopnea index (AHI), treated as a continuous variable, was associated with decreased CFI exclusively in females and with decreased daytime activity in the oldest age tertile (-6.41 [-10.64 to -2.17]). Finally, integrative data analysis revealed that an OSA profile characterized by a higher percentage of time with oxygen saturation below 90%, reduced total sleep time, and daytime sleepiness was associated with a pattern of circadian disruption, marked by increased IV, reduced RA, and diminished IS.
CONCLUSIONS: These findings suggest that the association between OSA and the circadian rest-activity rhythm is shaped by both patient-specific characteristics and disease-related factors, highlighting the importance of a patient-centered approach to managing potential circadian disruption in this context.