背景:本研究旨在探讨阻塞性睡眠呼吸暂停(OSA)与OSA之间的关系。昼夜节律,和个人的睡眠-觉醒偏好,按时间类型衡量,并评估昼夜节律基因表达与主观睡眠相关变量之间的关联。
方法:共招募184人,接受多导睡眠图(PSG),并完成了包括时间型问卷(CQ)在内的问卷,失眠严重程度指数(ISI),和Epworth嗜睡量表(ESS)。在PSG之前的晚上和之后的早晨收集血样。基因表达分析包括BMAL1,CLOCK,PER1、CRY1、NPAS2和NR1D1。
结果:在OSA组中,主观振幅(CQ的AM得分)与早晨的所有昼夜节律基因呈正相关(每个基因的R≥0.230和p<0.05),而早晚性(CQ的ME评分)仅与夜间BMAL1水平相关(R=0.192;p=0.044)。在健康的控制中,失眠严重程度与夜间BMAL1、PER1和CRY1的表达相关。
结论:这些发现强调了OSA之间复杂的相互作用,昼夜节律,和睡眠相关的变量,提示OSA中早晨时间型的潜在决定因素,并暗示全天的主观能量感受中昼夜节律功能中断。需要进一步的研究来阐明潜在的机制并指导个性化的管理策略。
BACKGROUND: This study aimed to investigate the relationship between obstructive sleep apnea (OSA), circadian rhythms, and individual sleep-wake preferences, as measured by chronotype, and to assess the association between circadian clock gene expression and subjective sleep-related variables.
METHODS: A total of 184 individuals were recruited, underwent polysomnography (PSG), and completed questionnaires including a chronotype questionnaire (CQ), insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Blood samples were collected in the evening before and morning after PSG. Gene expression analysis included BMAL1, CLOCK, PER1, CRY1, NPAS2, and NR1D1.
RESULTS: In the OSA group, the subjective amplitude (AM score of CQ) positively correlated with all circadian clock genes in the morning (R ≥ 0.230 and p < 0.05 for each one), while the morningness-eveningness (ME score of CQ) was only associated with the evening BMAL1 level (R = 0.192; p = 0.044). In healthy controls, insomnia severity correlated with evening expression of BMAL1, PER1, and CRY1.
CONCLUSIONS: The findings highlight the complex interplay between OSA, circadian rhythms, and sleep-related variables, suggesting potential determinants of morning chronotype in OSA and implicating disrupted circadian clock function in subjective feelings of energy throughout the day. Further research is warranted to elucidate underlying mechanisms and guide personalized management strategies.