慢性失眠症患者患高血压风险较高

  近日，一项刊登在国际杂志Hypertension上的研究论文中，来自中国四川大学等处的研究人员通过研究表示，花费超过14分钟才能入睡的失眠症患者或许会面临较高的高血压风险。相关研究由四川大学华西医院（West China Hospital）的研究人员进行，该研究首次检测了是否生理性过度觉醒的失眠症患者和高血压发病直接相关。

  研究者Xiangdong Tang说道，我们发现生理性过度觉醒的程度和高血压发病之间存在较强的相关性，换句话说，白天较为警觉，而且在多次睡眠潜伏期试验（MSLT）中不能放松或者入睡的失眠症患者或许患高血压的风险较高；失眠症发生在一般人群中的一种流行性睡眠障碍，1/4至1/3的普通人群都会存在难以入睡的情况，而且大约10%的个体都寻找过医疗救助。

  文章中，研究者对219名慢性失眠症患者及96名正常个体进行研究，研究对象的年龄平均为40岁，超过60%的个体为女性，研究者以超过6个月难以入睡来作为衡量慢性失眠症的衡量标准。首先参与者均在睡眠实验室进行了一晚上的监测，次日进行MLST测试，研究人员每两个小时进行一次监测。

  研究者表示，如果慢性失眠症患者的MLST分值超过14分钟则会增加个体患高血压风险300%，如果超过17分钟则会增加个体患高血压的风险400%。一天中入睡前较长的等待时间或许是衡量生理性过度觉醒的一个可靠指数，失眠症被认为是一种夜间睡眠障碍，然而很多研究都表明其属于24小时觉醒过度的一个状态。

  最后研究者表示，尽管失眠症患者抱怨自己在白天很疲惫，实际上问题是他们非常亢奋并不能放松下来。而本文研究对于有效预防失眠症患者患高血压及开发出新型疗法来有效治疗其疾病非常关键。（转化医学网360zhyx.com）

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转化医学网推荐的原文摘要：

Insomnia With Physiological Hyperarousal Is Associated With Hypertension
Hypertension doi: 10.1161/HYPERTENSIONAHA.114.04604
Yun Li, Alexandros N. Vgontzas, Julio Fernandez-Mendoza, Edward O. Bixler, Yuanfeng Sun, Junying Zhou, Rong Ren, Tao Li, Xiangdong Tang
Previous studies have suggested that insomnia with objective short sleep duration is associated with a higher risk of hypertension, and it has been speculated that the underlying mechanism is physiological hyperarousal. In this study, we tested whether insomnia with physiological hyperarousal measured by Multiple Sleep Latency Test (MSLT), a standard test of sleepiness/alertness, is associated with increased risk of hypertension. Two hundred nineteen chronic insomniacs and 96 normal sleepers were included in this study. Chronic insomnia was defined based on standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent 1 night in laboratory polysomnography followed by a standard MSLT. We used the median mean MSLT value (ie, >14 minutes) and the 75th percentile of mean MSLT value (ie, >17 minutes) to define hyperarousal. Hypertension was defined based either on blood pressure measures or on diagnosis treatment by a physician. After controlling for age, sex, body mass index, apnea–hypopnea index, diabetes mellitus, smoking, alcohol, and caffeine use, insomnia combined with MSLT >14 minutes increased the odds of hypertension by 300% (odds ratio=3.27; 95% confidence interval=1.20–8.96), whereas insomnia combined with MSLT >17 minutes increased even further the odds of hypertension by 400% (odds ratio=4.33; 95% confidence interval=1.48–12.68) compared with normal sleepers with MSLT ≤14 minutes. Insomnia associated with physiological hyperarousal is associated with a significant risk of hypertension. Long MSLT values may be a reliable index of the physiological hyperarousal and biological severity of chronic insomnia.