Зв’язок між тяжкістю порушень сну, показниками ліпідного обміну і антропометричними характеристиками у хворих на гіпертонічну хворобу з метаболічним синдромом

The aim – to assess correlations between insomnia, excessive daytime sleepiness (EDS) and levels of lipids, anthropometric parameters and cardiovascular risks in patients with hypertension and metabolic syndrom. Materials and methods. 118 patients with hypertension over 45 years of age were enrolled to this study. The Framingham Risk Score was used to evaluate cardiovascular risks and cardiovascular age. Body mass index, muscular strength, and physical activity (the number of steps per day) were assessed. Total cholesterol, triacylglycerols (TAGs), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose and glycated hemoglobin levels were determined. Insomnia was diagnosed in accordance with the International Classification of Sleep Disorders – Third Edition (ICSD-3). EDS was assessed by the Epworth Sleepiness Scale. To detect obstructive sleep apnea, a portable monitoring. Results and discussion. Insomnia was diagnosed in 48 (40.7 %) out of the 118 patients examined. No correlation between insomnia and either metabolic indices or arterial pressure was found. However, levels of systolic arterial pressure, HDL cholesterol, waist circumference, and body mass index were shown to differ depending on the severity of EDS. Analysis of cardiovascular age using the Framingham Risk Score revealed that patients with severe ESD were characterized by a greater cardiovascular age. In group 1 according to the Epworth Sleepiness Scale, it reached 48.0 [45.5–56.7] years, while in groups 2 and 3 this parameter was 57.0 [48.7–63.0] and 72.0 [68.0–80.0] years, respectively (ANOVA test, F=63,4; p=0.001). Conclusions. Thus, evaluation of the impact of sleep disorders on metabolic parameters and arterial hypertension allowed us to reveal that not insomnia itself but EDS as its manifestation is of huge importance. Our findings when using the Epworth Sleepiness Scale suggest that patients with moderate and severe EDS have higher levels of systolic arterial pressure, body mass index, waist circumference, lower HDL cholesterol, and greater cardiovascular age according to the Framingham Risk Score. The presence of insomnia was associated only with low level of high density cholesterol.