Association between refractory hypertension and obstructive sleep apnea.
Pimon Ruttanaumpawan1, Cherdchai Nopmaneejumruslers, Alexander G Logan
1Sleep Research Laboratory of the Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Journal of Hypertension
|May 8, 2009
Summary
Obstructive sleep apnea (OSA) and reduced REM sleep time are linked to higher odds of refractory hypertension (RHT). These sleep disturbances may contribute to the development of RHT.
Area of Science:
- Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Obstructive sleep apnea (OSA) is linked to mild hypertension.
- The relationship between OSA and refractory hypertension (RHT) requires further investigation.
- Rapid eye movement (REM) sleep deprivation may elevate blood pressure.
Purpose of the Study:
- To compare OSA prevalence and REM sleep duration in patients with RHT versus controlled hypertension.
- To determine if OSA and reduced REM sleep are associated with RHT.
Main Methods:
- A case-control study comparing 42 RHT patients with 22 controlled hypertension patients.
- Participants were matched for age, sex, and BMI.
- Sleep structure and OSA prevalence (apnea-hypopnea index > or = 10/hour) were assessed.
Main Results:
- RHT patients showed a significantly higher prevalence of OSA (81% vs. 55%, P=0.03).
- RHT patients had significantly less REM sleep time (47.0 min vs. 63.2 min, P=0.02).
- OSA (aOR=3.994) and reduced REM sleep (aOR=1.025) were independently associated with RHT.
Conclusions:
- OSA and reduced REM sleep time are associated with increased odds of RHT.
- These sleep abnormalities may play a role in the pathogenesis of refractory hypertension.
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