Obstructive sleep apnea during rapid eye movement sleep in patients with diabetic kidney disease
| Autor: | Takatoshi Kasai, Yasumichi Mori, Akihiro Nishimura, Kaoru Nagasawa, Shota Kikuno, Kimio Matsumura, Koji Narui, Minoru Okubo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty genetic structures Rapid eye movement sleep Sleep REM Type 2 diabetes Disease Diabetic angiopathy 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Diabetic Nephropathies Aged Sleep Apnea Obstructive Diabetic kidney business.industry musculoskeletal neural and ocular physiology Eye movement Middle Aged medicine.disease Scientific Investigations respiratory tract diseases Obstructive sleep apnea Cross-Sectional Studies Diabetes Mellitus Type 2 030228 respiratory system Neurology Cardiology Neurology (clinical) business Neurocognitive 030217 neurology & neurosurgery |
| Zdroj: | J Clin Sleep Med |
| ISSN: | 1550-9397 1550-9389 |
| Popis: | STUDY OBJECTIVES: Although recent studies suggest that obstructive sleep apnea during rapid eye movement (REM) is associated with different cardiometabolic and neurocognitive risks compared with non-REM (NREM) sleep, there is no information on whether obstructive sleep apnea during REM and/or NREM sleep is independently associated with diabetic kidney disease (DKD). METHODS: In this cross-sectional study, 303 patients with type 2 diabetes who were followed up at our diabetes outpatient clinic underwent all-night polysomnography. Logistic regression analysis was performed to determine the separate effects of obstructive sleep apnea during REM and/or NREM sleep (REM and/or NREM-apnea-hypopnea index [AHI]) and several other polysomnography parameters on DKD after adjustment for several known risk factors for DKD. RESULTS: The median (interquartile range) AHI, REM-AHI, and NREM-AHI of the patients (age 57.8 ± 11.8 years, male sex 86.8%, hypertension 64.3%, and DKD 35.2%) were 29.8 (18.0–45.4), 35.4 (21.1–53.3), and 29.1 (16.3–45.4) events/h, respectively. REM-AHI quartiles, but not NREM-AHI quartiles, correlated independently and significantly with DKD (P = .03 for linear trend, odds ratio (OR), and 95% confidence interval for Q2: 3.14 (1.10–8.98), Q3: 3.83 (1.26–11.60), Q4: 4.97 (1.60–15.46), compared with Q1). In addition, categorical AHI (P = .01, OR, and 95% confidence interval for ≥ 15 to < 30: 1.54 (0.64–3.71), ≥ 30: 3.08 (1.36–6.94) compared with < 15), quartiles of AHI (P = .01), quartiles of lowest arterial oxyhemoglobin saturation (P < .01), quartiles of percentage of time spent with arterial oxyhemoglobin saturation < 90 (P < .01), and quartiles of mean arterial oxyhemoglobin saturation were independently associated with DKD. CONCLUSIONS: Obstructive sleep apnea, especially during REM sleep, is a potential risk factor for DKD. CITATION: Nishimura A, Kasai T, Matsumura K, et al. Obstructive sleep apnea during rapid eye movement sleep in patients with diabetic kidney disease. J Clin Sleep Med. 2021;17(3):453–460. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|