睡眠心脏健康研究中阻塞性睡眠呼吸暂停症状表型与约5年后的躯体健康
Obstructive sleep apnea symptom phenotypes and physical health approximately 5 years later in the Sleep Heart Health Study.
文献信息
| PMID | 42826684 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xiu Shi |
| 作者单位 | Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China. |
| 期刊 | Sleep medicine |
| SCI 分区 | Q1 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 探讨四种已确立的阻塞性睡眠呼吸暂停（OSA）症状表型是否与约5年后的躯体健康和功能相关。
方法： 我们分析了睡眠心脏健康研究（SHHS）中1207名患有OSA的参与者。使用14个二分类症状指标和一个分类化的Epworth嗜睡量表评分，通过潜在类别分析重建了四种表型。随访时的躯体成分总结（PCS）和躯体功能（PF）评分采用多变量线性回归进行评估，并校正相应的基线评分和预先指定的协变量。纵向混合效应模型检验了表型与时间的交互作用。使用改良Poisson回归评估至少5分的下降。
结果： 该队列包括395名症状轻微、149名睡眠受扰、463名中度嗜睡和200名过度嗜睡的参与者。表型与随访时的PCS（总体P = 0.005）和PF（总体P = 0.021）相关。与症状轻微表型相比，过度嗜睡表型的PCS较低（校正差异，-3.77；95%置信区间[CI]，-6.09至-1.44；Holm校正P = 0.009），中度嗜睡表型也较低（-2.31；95% CI，-3.91至-0.72；Holm校正P = 0.023）。中度嗜睡表型的PF较低（-5.36；95% CI，-9.22至-1.50；Holm校正P = 0.039）。过度嗜睡表型发生PCS下降至少5分的风险更高（风险比，1.73；95% CI，1.17至2.56；Holm校正P = 0.019）。PCS（P = 0.646）或PF（P = 0.461）的表型与时间交互作用均不显著。
结论： 嗜睡性OSA症状表型与约5年后经基线校正的较低躯体健康相关。中度嗜睡表型的PCS和PF也较低，提示简单的嗜睡或非嗜睡分类可能无法捕捉具有临床相关性的症状异质性。
英文摘要
OBJECTIVE: To examine whether four established obstructive sleep apnea (OSA) symptom phenotypes were associated with physical health and functioning approximately 5 years later.
METHODS: We analyzed 1207 participants with OSA from the Sleep Heart Health Study (SHHS). Four phenotypes were reconstructed by latent class analysis using 14 binary symptom indicators and a categorized Epworth Sleepiness Scale score. Physical Component Summary (PCS) and Physical Functioning (PF) scores at follow-up were evaluated using multivariable linear regression with adjustment for the corresponding baseline score and prespecified covariates. Longitudinal mixed-effects models tested phenotype-by-time interactions. Declines of at least 5 points were evaluated using modified Poisson regression.
RESULTS: The cohort included 395 minimally symptomatic, 149 disturbed sleep, 463 moderately sleepy, and 200 excessively sleepy participants. Phenotype was associated with follow-up PCS (overall P = 0.005) and PF (overall P = 0.021). Compared with the minimally symptomatic phenotype, PCS was lower in the excessively sleepy phenotype (adjusted difference, -3.77; 95% confidence interval [CI], -6.09 to -1.44; Holm-adjusted P = 0.009) and the moderately sleepy phenotype (-2.31; 95% CI, -3.91 to -0.72; Holm-adjusted P = 0.023). PF was lower in the moderately sleepy phenotype (-5.36; 95% CI, -9.22 to -1.50; Holm-adjusted P = 0.039). The excessively sleepy phenotype had a higher risk of a PCS decline of at least 5 points (risk ratio, 1.73; 95% CI, 1.17 to 2.56; Holm-adjusted P = 0.019). Phenotype-by-time interactions were not significant for PCS (P = 0.646) or PF (P = 0.461).
CONCLUSIONS: Sleepy OSA symptom phenotypes were associated with lower baseline-adjusted physical health approximately 5 years later. The moderately sleepy phenotype also had lower PCS and PF, suggesting that a simple sleepy or nonsleepy classification may not capture clinically relevant symptom heterogeneity.