探討阻塞性睡眠呼吸中止症對男性久坐族群生化指標、睡眠結構與自律神經活性之影響

背景與目的: 阻塞型睡眠呼吸中止症(Obstructive Sleep Apnea, OSA)是近數十年來常見的睡眠障礙，其特徵為睡眠期間反覆出現呼吸中止與血氧濃度下降，並與心血管疾病、代謝症候群及日間嗜睡等多項健康問題密切相關。另一方面，久坐行為作為現代生活型態中日益普遍的新興風險因子，亦被證實與多種慢性疾病有間接關係。然而針對久坐族群在睡眠障礙及生理健康指標上的研究仍相對不足。為深入探討男性之睡眠品質與自律神經調控狀態，本研究透過整夜多項生理檢查(Polysomnography, PSG)，分析其睡眠結構與各睡眠期別下之心率變異性(Heart Rate Variability, HRV)表現，並同步檢測代謝、血球與發炎因子等生化指標，深入研究久坐行為於成年男性中於不同OSA嚴重程度下對生理指標與自律神經功能的影響。材料與方法: 本研究招募180名長期久坐之男性，篩選出心跳週期與睡眠週期較完整的125名受試者，受測者接受人口基本學調查、睡眠前後血壓監測、生化檢查與睡眠心律變異度監測，記錄受試者的睡眠結構及自律神經功能變化。依據OSA嚴重程度(AHI< 5，5 ≦AHI< 15，AHI≧ 15)及受測者年齡(大於小於40歲)進行分組及分析。結果與討論: 經過篩選後共有125位男性受測者，研究顯示中重度阻塞型睡眠呼吸中止症 (msOSA)組之睡前平均動脈壓 (NMBP)、睡醒後收縮壓 (DSBP)、睡醒後舒張壓 (DDBP)與睡醒後平均血壓 (DMBP)均顯著高於正常組，顯示心血管負荷增加。睡眠結構方面，中重度OSA組之N3期深層睡眠比例顯著低於正常組，而N1期淺層睡眠比例則顯著高於其他兩組。顯示隨病情惡化，睡眠品質明顯下降，且總臥床時間(TST)亦隨OSA嚴重程度增加而延長。進一步分析不同年齡層的表現發現，年輕組主要呈現自律神經活性下降與肝腎代謝功能異常；而中年組則在心血管壓力指標(如血壓)及多重代謝指標(尿酸與糖化血色素)方面出現更明顯異常。結論： 中重度OSA組在男性久坐族群個體具有較高的睡醒後血壓與較差的睡眠品質。進一步的年齡層分析則指出，年輕族群較易出現自律神經與肝腎代謝異常，中年族群則以心血管與生化代謝指標異常較為明顯。結果突顯OSA健康風險的年齡差異性，強調早期辨識與介入的重要性。

Background: Obstructive Sleep Apnea (OSA) has become one of the most prevalent sleep disorders in recent decades, characterized by repeated episodes of apnea and oxygen desaturation during sleep. It is closely associated with various health problems, including cardiovascular disease, metabolic syndrome, and excessive daytime sleepiness. Meanwhile, sedentary behavior has emerged as a widespread lifestyle-related risk factor in modern society and has been indirectly linked to the development of numerous chronic diseases. However, research exploring the relationship between sedentary behavior, sleep disorders, and physiological health indicators remains limited. To better understand sleep quality and autonomic regulation in adult males, this study conducted overnight polysomnography (PSG) to examine sleep architecture and heart rate variability (HRV) across different sleep stages. In addition, metabolic, hematological, and inflammatory biomarkers were assessed to comprehensively investigate how sedentary behavior, under varying degrees of OSA severity, affects physiological indicators and autonomic nervous system function in adult men.Method: This study recruited 180 sedentary adult males, from which 125 participants with more complete cardiac and sleep cycle data were selected for analysis. Each participant underwent a demographic survey, pre- and post-sleep blood pressure measurements, biochemical testing, and HRV monitoring during sleep to assess changes in sleep architecture and autonomic nervous system function. Participants were grouped and analyzed based on the severity of OSA (AHI < 5, 5 ≦ AHI < 15, AHI ≧ 15) and age (younger or older than 40 years).Result: Out of 180 participants, 125 sedentary males with complete data were included in the analysis. The moderate-to-severe OSA (msOSA) group showed significantly higher blood pressure readings, both before sleep (NMBP) and after waking (DSBP、DDBP、DMBP), indicating increased cardiovascular stress. Sleep analysis revealed a lower proportion of deep sleep (N3) and a higher proportion of light sleep (N1) in the msOSA group, reflecting poorer sleep quality and longer total sleep time (TST) with increasing OSA severity. Age group analysis showed that younger participants mainly exhibited reduced autonomic activity and liver/kidney metabolic issues, while middle-aged participants showed more pronounced abnormalities in blood pressure and metabolic markers such as uric acid and HbA1c.Conclusion: In sedentary male individuals, those with moderate-to-severe OSA exhibited higher blood pressure upon awakening and poorer sleep quality. Further age-stratified analysis revealed that younger individuals were more prone to autonomic nervous dysfunction and abnormalities in liver and kidney metabolism, whereas middle-aged individuals showed more pronounced cardiovascular and biochemical metabolic abnormalities. These findings highlight the age-related differences in OSA-associated health risks and emphasize the importance of early identification and intervention.