It is well-known that OSA produces intermittent hypoxemia and hypercapnia, sleep fragmentation, and cardio-sympathetic alterations including elevated blood pressure and heart rate (Javaheri S et al 2017; Heinzer R et al 2015; Kasai T 2011).
This study explores the relationship between REM-OSA and hypertension. A large sample size of 797 participants was analysed using regression modelling at Eastern Health in Melbourne, Australia. The researchers examined the probability of evening and morning hypertensive BP levels according to REM apnoea-hypopnea index (AHI), NREM AHI, gender, age, body mass index (BMI), alcohol use, total sleep time (TST), sleep time SpO2 <90%, and smoking status.
The probability of morning hypertensive BP levels was significant and independently associated with age (p < .001), BMI (p < .001), and REM AHI (p < .001). No significant effect was found for the male gender, NREM AHI, alcohol use, TST, sleep time SpO2 <90%, or smoking (p > .05 for all). The probability of evening hypertensive BP levels was only significantly associated with age (p < .001), male gender (p = .012), BMI (p < .001), and TST (p = .032).
The authors concluded that respiratory events during REM sleep are significantly associated with morning hypertensive BP levels.
Author: Erika Mateus (BNus, MNus), Sleep Scientist
References
- Catherine Falla and others, Obstructive sleep apnea during REM sleep: effects on morning and evening blood pressure, Sleep, Volume 46, Issue 3, March 2023, zsac259, https://doi.org/10.1093/sleep/zsac259.
- Javaheri S, et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol. 2017;69(7):841–858. doi: 10.1016/j.jacc.2016.11.069.
- Heinzer R, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med.2015;3(4):310–318. doi: 10.1016/S2213-2600(15)00043-0.
- Kasai T, et al. Obstructive sleep apnea and heart failure. J Am Coll 2011;57(2):119–127. doi: 10.1016/j.jacc.2010.08.627
