| Zhao Rui,Yao Ping,Zhang Zhiqiang,Guo Zhiguo,Xie Minqi,Dang Hui,Jia Yanrong,Cheng Jing,Lyu Dongsheng,Differences in arousal threshold among obstructive sleep apnea patients of different genetic backgrounds and influencing factors[J].SICHUAN MENTAL HEALTH,2026,(3):240-245 |
| Differences in arousal threshold among obstructive sleep apnea patients of different genetic backgrounds and influencing factors |
DOI：10.11886/scjsws20250516001 |
| English keywords:Arousal threshold Obstructive sleep apnea Polysomnography |
| Fund projects:内蒙古自治区自然科学基金项目（项目名称：阻塞性睡眠呼吸暂停增加脑小血管负荷及其机制的研究，项目编号：2024QN08050）；内蒙古自治区精神卫生中心院内科研项目（项目名称：阻塞性睡眠呼吸暂停患者不同觉醒阈值的研究，项目编号：2022QNWN0010） |
| Author Name | Affiliation | Postcode | | Zhao Rui | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Yao Ping | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Zhang Zhiqiang | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Guo Zhiguo | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Xie Minqi | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Dang Hui | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Jia Yanrong | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Cheng Jing | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 | | Lyu Dongsheng* | Inner Mongolia Mental Health Center （The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region）, Hohhot 010010, China | 010010 |
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| English abstract: |
| Background Obstructive sleep apnea （OSA） represents a prevalent sleep disordered breathing condition characterized by complex pathophysiology. The arousal threshold （ArTH）， a core non-anatomical contributor to OSA pathogenesis， is intimately tied to the disease severity and clinical phenotypes. To date， research regarding factors associated with ArTH has yielded inconsistent findings， and ArTH profiles and disparities across populations with different genetic backgrounds are not fully elucidated.Objective To explore the differences of ArTH in OSA patients with different genetic backgrounds and analyze the key factors affecting ArTH， thereby providing evidence for understanding OSA pathophysiology and formulating targeted treatment regimens.Methods A total of 285 patients who met the diagnostic criteria for OSA， as defined by the Multidisciplinary Diagnosis and Treatment Guidelines for Adult Obstructive Sleep Apnea， were retrospectively enrolled in this study. All participants underwent overnight polysomnography （PSG） at the Sleep Medicine Center of Inner Mongolia Mental Health Center from December 2022 to May 2024. Based on the study design， the cohort was stratified into two distinct genetic background subgroups （group A and group B）. Demographic and clinical characteristics， the Epworth Sleepiness Scale （ESS） score， and overnight PSG data were collected. The apnea hypopnea index （AHI）， the lowest pulse oxygen saturation （LSpO2）， and fraction of hypopneas （FHypopneas） were utilized as surrogate indicators to estimate ArTH in OSA patients. The influencing factors of low ArTH were tested by binary Logistic regression analysis.Results Among the 285 OSA patients， there were 227 cases （79.65%） in group A and 58 cases （20.35%） in group B. Comparisons between the two genetic background subgroups revealed no statistically significant differences in the proportion of low ArTH， ESS score， PSG parameters， and the three markers for low ArTH （AHI<30 events/h， LSpO2>82.5%， FHypopneas>58.3%） （P>0.05）. Binary Logistic regression analysis identified sex （OR=2.421， 95% CI： 1.070–5.478）， BMI （OR=0.847， 95% CI： 0.770–0.932）， N1 sleep duration （OR=0.974， 95% CI： 0.963–0.985）， and hypertension （OR=0.348， 95% CI： 0.143–0.848） as independent factors associated with low ArTH in the total cohort. Stratified analysis by genetic backgrounds revealed that sex（OR=3.799， 95% CI： 1.389–10.392）， BMI（OR=0.819， 95% CI：0.723–0.929）， and N1 sleep duration（OR=0.973， 95% CI： 0.961–0.986） were independent factors of low ArTH in group A. In contrast， only N1 sleep duration （OR=0.951， 95% CI： 0.911–0.993） remained a significant factor in group B.Conclusion Arthur may have conservative characteristics in patients with OSA with different genetic backgrounds， but the pathophysiological mechanism of OSA may have population heterogeneity. ［Funded by Inner Mongolia Autonomous Region Natural Science Fundation Project （number， 2024QN08050）； Intra-institutional Scientific Research Project of Inner Mongolia Mental Health Center （number， 2022QNWN0010）］ |
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