Hypertension is associated with undiagnosed obstructive sleep apnea during rapid eye movement (REM) sleep

Background

Evidence linking obstructive sleep apnea (OSA) with hypertension in population studies is conflicting. We examined longitudinal and cross-sectional associations of previously unrecognized OSA, including OSA occurring in rapid eye movement (REM) sleep, with hypertension.background

Methods

The Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) Study is a longitudinal study of community-dwelling men in Adelaide, South Australia. Biomedical assessments at baseline (2002-2006) and follow-up (2007-2010) identified hypertension (systolic ≥140mm Hg and/or diastolic ≥ 90mm Hg, or medication) and risk factors. In 2010-2011, 837 men without a prior diagnosis of OSA underwent full in-home unattended polysomnography (PSG, Embletta X100) of whom739 recorded ≥30 min of REM sleep. Hypertension at follow-up (concomitant with OSA status) was defined as prevalent hypertension. Recent-onset hypertension was defined as hypertension at biomedical follow-up [56 months mean follow-up (range: 48-74)] in men free of hypertension at baseline.

Results

Severe REM OSA [apnea hypopnea index (AHI)REM ≥30/h) showed independent adjusted associations with prevalent [odds ratio (OR): 2.40, 95% confidence interval (CI): 1.42-4.06], and recent-onset hypertension (2.24, 1.04-4.81). Significant associations with non-REM AHI (AHINREM) were not seen. In men with AHIConclusions

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