气道正压即刻血流动力学稳定：分夜多导睡眠监测中基于脉搏传导时间的夜间血压波动
Immediate hemodynamic stabilization with positive airway pressure: PTT-derived nocturnal blood pressure fluctuations during split-night polysomnography.
文献信息
| PMID | 42754769 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Deepesh Vaidya |
| 作者单位 | Sleep Laboratory, Health City Cayman Islands, Grand Cayman, Cayman Islands. vaidyadeepeshvaidya@gmail.com. |
| 期刊 | Sleep & breathing = Schlaf & Atmung |
| SCI 分区 | Q3 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
研究目的： 评估分夜多导睡眠监测期间气道正压（PAP）治疗对基于脉搏传导时间（PTT）的夜间血压波动（NBPF）的即刻血流动力学效应，并确定该效应在高血压与非高血压个体之间是否存在差异。
方法： 这项回顾性队列研究纳入2015年至2023年间接受分夜多导睡眠监测的464名成人。NBPF定义为通过制造商验证算法校准的PTT推导的收缩压（SBP）标准差。组内变化采用配对t检验评估，组间比较采用独立t检验，多变量线性回归调整年龄和基线NBPF。计算效应量（Cohen's d）和95%置信区间（CI）。
结果： PAP治疗后，高血压组（平均降低20.71±24.25 mmHg，p<0.001）和非高血压组（18.97±23.58 mmHg，p<0.001）的NBPF均显著下降。效应量大（Cohen's d分别为0.96和0.90）。调整后组间NBPF降低差异不显著（β=1.42 mmHg；95% CI -3.21至6.05；p=0.54）。
结论： 分夜研究期间PAP治疗产生即刻血流动力学稳定，表现为高血压和非高血压患者夜间血压变异性均大幅且显著降低。这些发现支持早期启动PAP以减轻夜间血压不稳定性，无论基线高血压状态如何。
英文摘要
STUDY OBJECTIVES: To evaluate the immediate hemodynamic effect of positive airway pressure (PAP) therapy on pulse transit time (PTT)-derived nocturnal blood pressure fluctuation (NBPF) during split-night polysomnography and to determine whether this effect differs between hypertensive and non-hypertensive individuals.
METHODS: This retrospective cohort study included 464 adults undergoing split-night polysomnography between 2015 and 2023. NBPF was defined as the standard deviation of systolic blood pressure (SBP) derived from PTT calibrated using manufacturer-validated algorithms. Within-group changes were assessed using paired t-tests, between-group comparisons used independent t-tests, and multivariable linear regression adjusted for age and baseline NBPF. Effect sizes (Cohen's d) and 95% confidence intervals (CI) were calculated.
RESULTS: NBPF decreased significantly after PAP therapy in both hypertensive (mean reduction 20.71 ± 24.25 mmHg, p < 0.001) and non-hypertensive groups (18.97 ± 23.58 mmHg, p < 0.001). Effect sizes were large (Cohen's d = 0.96 and 0.90, respectively). The adjusted between-group difference in NBPF reduction was not significant (β = 1.42 mmHg; 95% CI - 3.21 to 6.05; p = 0.54).
CONCLUSIONS: PAP therapy during split-night studies produces immediate hemodynamic stabilization, reflected by a large and significant reduction in nocturnal BP variability in both hypertensive and non-hypertensive patients. These findings support early PAP initiation to mitigate nocturnal BP lability regardless of baseline hypertension status.