Abstract 2462: Obstructive Sleep Apnea Treatment Improves the Blood Pressure Behavior in Normotensive Patients: A Randomized Study

Introduction: Obstructive sleep apnea (OSA) promotes significant alterations on blood pressure during sleep. In patients with concomitant hypertension, the treatment with continuous positive airway pressure (CPAP) promotes significant reductions on blood pressure. However, the impact of CPAP on 24 hour blood pressure in normotensive patients is poorly understood. Methods: We included 22 apparently healthy patients with severe OSA defined by polysomnography (apnea/hypopnea index (AHI) >30 events/hour). We excluded hypertension according current guidelines by office measurements. They were randomized to no treatment (control) or CPAP for 3 months. At baseline and at the end of the protocol, we performed 24 hour blood pressure (BP) monitoring evaluating daytime and nighttime BP as well as the morning surge (average of systolic BP during the 2 hours after awakening minus the average of systolic BP during the 1 hour that included the lowest nighttime BP) and highest systolic nighttime BP (mean of 3 BP measurements, centered on the highest nighttime reading). Results: After 3 months, patients randomized to CPAP (mean CPAP usage: 6 hours) presented a significant reduction on daytime (80.3±6.3 to 75.3±6.9 mmHg; P=0.02) and nighttime diastolic BP (67.8±9.5 to 61.4±7.5 mmHg; P=0.03). In addition, we observed a significant reduction on highest nighttime systolic BP (120.0±13.6 to 112.0±.9 mmHg; P=0.02) with a trend for a reduction on morning surge (22.3±9.2 to 17.3±.4 mmHg; P=0.08). No significant alterations occurred in the control group. Conclusion: Even in the absence of established hypertension, CPAP therapy improved the behavior of 24 hour BP in patients with severe OSA.

Download Full-text

Blood pressure profiles in patients with arterial hypertension and obstructive sleep apnea in different age groups

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-5-530-535 ◽

2021 ◽

Vol 27 (5) ◽

pp. 530-535

Author(s):

A. N. Kuchmin ◽

V. V. Ekimov ◽

D. A. Galaktionov ◽

I. M. Borisov ◽

A. A. Sheveliov ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Age Groups ◽

Pressure Profile ◽

Control Group ◽

Apnea Hypopnea Index ◽

Blood Pressure Profile ◽

Pressure Profiles ◽

Obstructive Sleep

Background. Obstructive sleep apnea (OSA) is frequently associated with hypertension (HTN), and about 50 % hypertensive patients have concomitant OSA. Episodes of transient upper airway obstruction affect the daily blood pressure profile, leading to nocturnal HTN. Although the general relationship between OSA and the daily blood pressure profile is known, the association between the frequency of various daily blood pressure profiles and OSA severity as well as the age-specific differences remain unknown. The aim of the study was to determine the daily blood pressure profiles in patients with HTN and OSA, depending on the OSA severity and age. Design and methods. The study included 236 HTN patients underwent treatment in the period from 2008 to 2021 years and were diagnosed with OSA by cardiorespiratory monitoring: 84 patients had mild OSA (apnea/hypopnea index (AHI) < 15 episodes/h), 46 patients — moderate OSA (15 ≤ AHI < 30 episodes/h), and 106 patients — severe OSA (AHI ≥ 30 episodes/h). The control group included 140 HTN patients without OSA. Both groups were divided into 3 age subgroups: younger than 45 years, 45–59 years and ≥ 60 years. At baseline, all patients underwent cardiorespiratory monitoring (“Kardiotekhnika‑07–3/12P”, Inkart, St Petersburg, Russia) and 24-hour blood pressure (BP) monitoring (BPLab, Nizhny Novgorod, Russia). Results. We found an association between the distribution of daily BP profiles and age, which differs from that in HTN patients without OSA. Non-dipper and night-peaker BP profiles are predominant in young and middle age. Among OSA patients, the severity of OSA was associated with the BP profiles only in the young and middleage groups. Unfavorable BP profiles (non-dipper and night-peaker) were more common in patients with severe OSA, which was not observed in elderly subgroup. In the elderly, compared to younger patients, the overdipper profile was the most common and its frequency was not associated with OSA severity. Conclusions. The study shows the relationship between the age of patients with HTN and OSA, the OSA severity and the distribution of daily BP profiles.

Download Full-text

Irisin Is Correlated with Blood Pressure in Obstructive Sleep Apnea Patients

International Journal of Hypertension ◽

10.1155/2021/4717349 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Xing Wang ◽

Zhengjiao Zhang ◽

Xiaoxin Lan ◽

Keyou Fu ◽

Guanhua Xu ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Secondary Hypertension ◽

The Other ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Apnea Hypopnea Index ◽

Potential Biomarker ◽

Obstructive Sleep

Background. Despite approximately 95% primary cases of hypertension, secondary hypertension seems to be common with resistant forms. Notably, obstructive sleep apnea (OSA) is known as a common cause of secondary hypertension and has a major characteristic of obesity. Irisin acts as a link between muscles and adipose tissues in obesity, playing an essential role in human blood pressure (BP) regulation. However, whether irisin is associated with secondary hypertension caused by OSA and how it takes effect essentially have not been elucidated. Purpose. To investigate the changes of irisin and its relationship with BP in OSA. Methods. 72 snoring patients finished Epworth Sleep Scale (ESS) evaluation before polysomnography (PSG). BP was the average of three brachial BP values by mercury sphygmomanometer. Serum irisin level was determined by enzyme-linked immunosorbent assay (ELISA). Results were analyzed by SPSS software. Results. Irisin was higher in the severe and quite severe group than that in control and nonsevere groups ( p < 0.05 ). For BP, significant differences were found between the control group and the other three groups ( p < 0.05 ) and between the quite severe and the other three groups ( p ≤ 0.001 ). Positive correlations were found between irisin and apnea-hypopnea index (AHI), AHI and BP, and irisin level and BP. Negative correlations were between irisin and SpO2 nadir and SpO2 nadir and BP. Positive correlation still existed between AHI and irisin even after adjusting for some obesity-related variables. Conclusions. Irisin may serve as a potential biomarker for severity of OSA independently of obesity and imply the development of hypertension.

Download Full-text

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽

10.1159/000516243 ◽

2021 ◽

pp. 1-8

Author(s):

Lifeng Li ◽

Demin Han ◽

Hongrui Zang ◽

Nyall R. London

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Nasal Obstruction ◽

Upper Airway ◽

Apnea Hypopnea Index ◽

Nasal Surgery ◽

Subjective Sleep Quality ◽

Obstructive Sleep ◽

Significant Difference ◽

The Impact

Objective: The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. Methods: Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. Results: By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (p < 0.05), while the Apnea-Hypopnea Index (AHI) changed little (p = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all p < 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (p < 0.05), except with the AHI (p > 0.05). Conclusion: Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

Download Full-text

High Plasma Cystine Levels Are Associated with Blood Pressure and Reversed by CPAP in Patients with Obstructive Sleep Apnea

Journal of Clinical Medicine ◽

10.3390/jcm10071387 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1387

Author(s):

Raphael Boneberg ◽

Anita Pardun ◽

Lena Hannemann ◽

Olaf Hildebrandt ◽

Ulrich Koehler ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Mononuclear Cells ◽

Vascular Risk Factor ◽

High Plasma ◽

Apnea Hypopnea Index ◽

Hypoxic Stress ◽

Peripheral Blood Mononuclear ◽

Obstructive Sleep

Obstructive sleep apnea (OSA) independent of obesity (OBS) imposes severe cardiovascular risk. To what extent plasma cystine concentration (CySS), a novel pro-oxidative vascular risk factor, is increased in OSA with or without OBS is presently unknown. We therefore studied CySS together with the redox state and precursor amino acids of glutathione (GSH) in peripheral blood mononuclear cells (PBMC) in untreated male patients with OSA (apnea-hypopnea-index (AHI) > 15 h−1, n = 28) compared to healthy male controls (n = 25) stratifying for BMI ≥ or < 30 kg m−2. Fifteen OSA patients were reassessed after 3–5-months CPAP. CySS correlated with cumulative time at an O2-saturation <90% (Tu90%) (r = 0.34, p < 0.05) beside BMI (r = 0.58, p < 0.001) and was higher in subjects with “hypoxic stress” (59.4 ± 2.0 vs. 50.1 ± 2.7 µM, p < 0.01) defined as Tu90% ≥ 15.2 min (corresponding to AHI ≥ 15 h−1). Moreover, CySS significantly correlated with systolic (r = 0.32, p < 0.05) and diastolic (r = 0.31, p < 0.05) blood pressure. CPAP significantly lowered CySS along with blood pressure at unchanged BMI. Unexpectedly, GSH antioxidant capacity in PBMC was increased with OSA and reversed with CPAP. Plasma CySS levels are increased with OSA-related hypoxic stress and associated with higher blood pressure. CPAP decreases both CySS and blood pressure. The role of CySS in OSA-related vascular endpoints and their prevention by CPAP warrants further studies.

Download Full-text

Endothelial Function and Arterial Stiffness Should Be Measured to Comprehensively Assess Obstructive Sleep Apnea in Clinical Practice

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.716916 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jinmei Luo ◽

Xiaona Wang ◽

Zijian Guo ◽

Yi Xiao ◽

Wenhao Cao ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Arterial Stiffness ◽

Endothelial Function ◽

Augmentation Index ◽

Reactive Hyperemia ◽

Control Group ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

Tnf Α

Objective: An effective clinical tool to assess endothelial function and arterial stiffness in patients with obstructive sleep apnea (OSA) is lacking. This study evaluated the clinical significance of subclinical markers for OSA management in males without serious complications.Patients/Methods: Males without serious complications were consecutively recruited. Clinical data, biomarker tests, reactive hyperemia index (RHI), and augmentation index at 75 beats/min (AIx75) measured by peripheral arterial tonometry were collected. An apnea hypopnea index (AHI) cutoff of ≥15 events/h divided the patients into two groups.Results: Of the 75 subjects, 42 had an AHI ≥15 events/h. Patients with an AHI ≥15 events/h had higher high-sensitivity C-reactive protein, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor, and AIx75 values than the control group but no statistical difference in RHI was observed. After controlling for confounders, TNF-α was negatively correlated with the average oxygen saturation (r = −0.258, P = 0.043). RHI was correlated with the rapid eye movement (REM) stage percentage (r = 0.306, P = 0.016) but not with AHI (P > 0.05). AIx75 was positively correlated with the arousal index (r = 0.289, P = 0.023) but not with AHI (r = 0.248, P = 0.052).Conclusions: In males with OSA without severe complications, TNF-α and AIx75 are independently related to OSA. The role of RHI in OSA management requires further elucidation. These markers combined can comprehensively evaluate OSA patients to provide more evidence for the primary prevention of coronary heart disease and treatment response assessment.

Download Full-text

Abstract 14965: Atrial Conduction During Obstructive Sleep Apnea: Comparison of Stacked Versus Isolated Apnea Episodes

Circulation ◽

10.1161/circ.142.suppl_3.14965 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Krishan Patel ◽

Hussain Basrawala ◽

Pavan Reddy ◽

Edwin Valladares ◽

Vincent Grbach ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

P Wave ◽

Conduction Delay ◽

Apnea Hypopnea Index ◽

Peripheral Oxygen Saturation ◽

Cardiovascular Comorbidities ◽

Obstructive Sleep ◽

Cost Efficient ◽

The Impact

Introduction: Obstructive sleep apnea (OSA) is associated with increased rates of atrial fibrillation (AF). Recent randomized data suggest that traditional scoring of OSA needs to evolve to improve cardiovascular outcomes. Traditional scoring of OSA does not fully reflect pathophysiological links between OSA and AF, particularly regarding OSA-induced prolongation of p-wave duration (PWD), which is the most powerful predictor of AF occurrence. Hypothesis: We hypothesized that OSA episodes that closely follow each other (serially stacked apneas, ssOSA) exert greater effect on PWD compared to isolated OSA (iOSA) episodes. Methods: Sleeping patients (adults with mild-moderate OSA and presence of both iOSA and ssOSA, but without other cardiovascular comorbidities) undergoing diagnostic polysomnography were recorded by continuous 8-lead ECG. iOSA was defined as OSA episodes with no other episode within 30 seconds. ssOSA consisted of ≥3 consecutive apneas with inter-OSA intervals <30 seconds. PWD was defined from onset of p-wave in any ECG lead to termination in any lead (measured by digital calipers, averaged over 3 beats from first half of OSA and 3 beats from second half of OSA). Wilcoxon rank-sum test was used. Results: We analyzed 208 OSA episodes (51.0% iOSA, 49.0% ssOSA) which occurred in 12 patients (7 women; age 63.1±11.5 years; apnea hypopnea index 16.8±5.4). PWD was longer during ssOSA compared to iOSA (median 117.7ms vs 109.6ms; p<0.0001). The following variables did not differ between ssOSA and iOSA: PR interval (p=0.3139), RR interval (p=0.7531), peripheral oxygen saturation (p=0.7776). Conclusions: The impact of OSA on atrial conduction delay is exacerbated by the phenomenon of OSA stacking, which seems independent of oxygen desaturation and heart rate. Stacking of OSA episodes may be an underused and cost-efficient variable in evaluating the severity of OSA and the effectiveness of OSA treatments with the ultimate goal of reducing occurrence of AF.

Download Full-text

Polysomnographic Outcomes After Observation for Mild Obstructive Sleep Apnea in Children Younger Than 3 Years

Otolaryngology ◽

10.1177/0194599820954383 ◽

2020 ◽

pp. 019459982095438

Author(s):

Kathleen M. Sarber ◽

Douglas C. von Allmen ◽

Raisa Tikhtman ◽

Javier Howard ◽

Narong Simakajornboon ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Care Center ◽

Tertiary Care ◽

Apnea Hypopnea Index ◽

Optimal Timing ◽

Obstructive Apnea ◽

Obstructive Sleep ◽

Mild Obstructive Sleep Apnea ◽

The Impact

Objective Mild obstructive sleep apnea (OSA), particularly in young children, is often treated with observation. However, there is little evidence regarding the outcomes with this approach. Our aim was to assess the impact of observation on sleep for children aged <3 years with mild OSA. Study Design Case-control study. Setting Pediatric tertiary care center. Methods We reviewed cases of children (<3 years old) diagnosed with mild OSA (obstructive apnea-hypopnea index, 1-5 events/h) who were treated with observation between 2012 and 2017 and had at least 2 polysomnograms performed 3 to 12 months apart. Demographic data and comorbid diagnoses were collected. Results Twenty-six children met inclusion criteria; their median age was 7.2 months (95% CI, 1.2-22.8). Nine (35%) were female and 24 (92%) were White. Their median body mass index percentile was 39 (95% CI, 1-76). Comorbidities included cardiac disease (42.3%), laryngomalacia (42.3%), allergies (34.6%), reactive airway disease (23.1%), and prematurity (7.7%). The obstructive apnea-hypopnea index significantly decreased from 2.7 events/h (95% CI, 1-4.5) to 1.3 (95% CI, 0-4.5; P = .013). There was no significant improvement in median saturation nadir (baseline, 86%; P = .76) or median time with end-tidal carbon dioxide >50 mm Hg (baseline, 0 minutes; P = .34). OSA resolved in 8 patients (31%) and worsened in 1 (3.8%). Only race was a significant predictor of resolution per regression analysis; however, only 2 non-White children were included. Conclusion In our cohort, resolution of mild OSA occurred in 31% of patients treated with 3 to 12 months of observation. The presence of laryngomalacia, asthma, and allergies did not affect resolution. Larger studies are needed to better identify factors (including race) associated with persistent OSA and optimal timing of intervention for these children. Level of Evidence 4.

Download Full-text

Polysomnography Outcomes after Supraglottoplasty in Children with Obstructive Sleep Apnea

Otolaryngology ◽

10.1177/0194599819844512 ◽

2019 ◽

Vol 161 (4) ◽

pp. 694-698 ◽

Cited By ~ 3

Author(s):

Bharat Bhushan ◽

James W. Schroeder ◽

Kathleen R. Billings ◽

Nicholas Giancola ◽

Dana M. Thompson

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Tertiary Care ◽

Case Series ◽

Apnea Hypopnea Index ◽

Historical Cohort ◽

Tertiary Care Medical Center ◽

Obstructive Sleep ◽

The Mean ◽

The Impact

ObjectiveLaryngomalacia has been reported to contribute to the severity of obstructive sleep apnea (OSA) in children. It is unclear if surgical treatment of laryngomalacia improves polysomnography (PSG) outcomes in these patients. The objective of this study is to report the impact of supraglottoplasty on PSG parameters in children with laryngomalacia-related OSA.Study DesignRetrospective case series.SettingTertiary care medical center.Subjects and MethodsHistorical cohort study of consecutive children with laryngomalacia who underwent supraglottoplasty and who had undergone overnight PSG before and after surgery.ResultsForty-one patients were included in the final analysis: 22 (53.6%) were male, and 19 (46.3%) were female. The mean ± SEM age of patients at preoperative PSG was 1.3 ± 0.89 years (range, 0.003-2.9). In entire cohort, the mean obstructive apnea-hypopnea index score was reduced from 26.6 events/h before supraglottoplasty to 7.3 events/h after surgery ( P = .003). Respiratory disturbance index was reduced from 27.3 events/h before supraglottoplasty to 7.8 events/h after surgery ( P = .003). The percentage of REM sleep decreased from 30.1% ± 2.4 to 24.8% ± 1.3 ( P = .04). Sleep efficiency was improved ( P = .05).ConclusionOverall, supraglottoplasty significantly improved several PSG outcomes in children with laryngomalacia. However, mild to moderate OSA was still present postoperatively in most children. This suggested a multifactorial cause for OSA in this population.

Download Full-text

Prospective Screening for Primary Aldosteronism in Patients With Suspected Obstructive Sleep Apnea

Hypertension ◽

10.1161/hypertensionaha.120.16902 ◽

2021 ◽

Author(s):

Min Ru Chee ◽

Jesse Hoo ◽

Renata Libianto ◽

Stella M. Gwini ◽

Garun Hamilton ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Primary Aldosteronism ◽

Blood Pressure Monitoring ◽

Apnea Hypopnea Index ◽

Hypertension Status ◽

Antihypertensive Medications ◽

Sleep Study ◽

Obstructive Sleep

Several studies have demonstrated a bidirectional relationship between obstructive sleep apnea and primary aldosteronism (PA); however, many of these studies are limited to patients with known obstructive sleep apnea, hypertension, or PA. We evaluated the role of screening for PA in all patients referred for a diagnostic sleep study without selecting for prior diagnoses with these conditions. Plasma aldosterone and renin concentration were measured after an overnight polysomnography. Blood pressure was measured at the sleep center for all patients, while a proportion underwent 24-hour blood pressure monitoring. Of the 85 participating patients, 2 (2.4%) were identified to have likely PA based on an elevated aldosterone:renin ratio and/or clinical characteristics. Another 10 (11.8%) were identified to have possible PA based on their low or normal plasma renin concentration despite taking antihypertensive medications that are known to elevate renin. In participants with both obstructive sleep apnea and hypertension (n=40), the prevalence of likely or possible PA was 30%. However, there was no correlation between aldosterone, rennin, or aldosterone:renin ratio and the apnea-hypopnea index using multiple regression analysis adjusted for interfering medications and hypertension status. The observed high prevalence of possible PA among those with both hypertension and obstructive sleep apnea suggests that they should be routinely screened for PA.

Download Full-text

Effect of Maternal Obstructive Sleep Apnea-Hypopnea on 24-Hour Blood Pressure, Nocturnal Blood Pressure Dipping and Arterial Stiffness in Hypertensive Disorders of Pregnancy

Frontiers in Physiology ◽

10.3389/fphys.2021.747106 ◽

2021 ◽

Vol 12 ◽

Author(s):

Pattaraporn Panyarath ◽

Noa Goldscher ◽

Sushmita Pamidi ◽

Stella S. Daskalopoulou ◽

Robert Gagnon ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Arterial Stiffness ◽

Hypertensive Disorders Of Pregnancy ◽

Adjusted Analysis ◽

Nocturnal Blood Pressure ◽

Hypertensive Disorders ◽

Obstructive Sleep ◽

The Impact

Rationale: Maternal obstructive sleep apnea-hypopnea (OSAH) is associated with hypertensive disorders of pregnancy (HDP). Attenuation of the normal nocturnal blood pressure (BP) decline (non-dipping) is associated with adverse pregnancy outcomes. OSAH is associated with nocturnal non-dipping in the general population, but this has not been studied in pregnancy. We therefore analyzed baseline data from an ongoing RCT (NCT03309826) assessing the impact of OSAH treatment on HDP outcomes, to evaluate the relationship of OSAH to 24-h BP profile, in particular nocturnal BP dipping, and measures of arterial stiffness.Methods: Women with a singleton pregnancy and HDP underwent level II polysomnography. Patients with OSAH (apnea-hypopnea index (AHI) ≥ 5 events/h) then underwent 24-h ambulatory BP monitoring and arterial stiffness measurements (applanation tonometry, SphygmoCor). Positive dipping was defined as nocturnal systolic blood pressure (SBP) dip ≥ 10%. The relationships between measures of OSAH severity, measures of BP and arterial stiffness were evaluated using linear regression analyses.Results: We studied 51 HDP participants (36.5 ± 4.9 years, BMI 36.9 ± 8.6 kg/m2) with OSAH with mean AHI 27.7 ± 26.4 events/h at 25.0 ± 4.9 weeks’ gestation. We found no significant relationships between AHI or other OSA severity measures and mean 24-h BP values, although BP was generally well-controlled. Most women were SBP non-dippers (78.4%). AHI showed a significant inverse correlation with % SBP dipping following adjustment for age, BMI, parity, gestational age, and BP medications (β = −0.11, p = 0.02). Significant inverse correlations were also observed between AHI and DBP (β = −0.16, p = 0.01) and MAP (β = −0.13, p = 0.02) % dipping. Oxygen desaturation index and sleep time below SaO2 90% were also inversely correlated with % dipping. Moreover, a significant positive correlation was observed between carotid-femoral pulse wave velocity (cfPWV) and REM AHI (β = 0.02, p = 0.04) in unadjusted but not adjusted analysis.Conclusion: Blood pressure non-dipping was observed in a majority of women with HDP and OSAH. There were significant inverse relationships between OSAH severity measures and nocturnal % dipping. Increased arterial stiffness was associated with increasing severity of OSAH during REM sleep in unadjusted although not adjusted analysis. These findings suggest that OSAH may represent a therapeutic target to improve BP profile and vascular risk in HDP.

Download Full-text