Abstract
Rapid eye movement-predominant obstructive sleep apnea has been shown to be independently associated with hypertension. This study aimed to non-invasively measure blood pressure during the rapid eye movement (REM) and non-rapid eye movement (NREM) obstructive events and the post-obstructive event period. Thirty-two consecutive continuous positive airway pressure-naïve obstructive sleep apnea patients (men, 50%) aged 50.2 ± 12 years underwent overnight polysomnography. Blood pressure was assessed indirectly using a validated method based on the pulse transit time and pulse wave velocity during the NREM and REM obstructive events (both apneas and hypopneas) and the post-obstructive event period. Among the recruited patients, 10 (31.3%) had hypertension. Mean apnea-hypopnea index was 40.1 ± 27.6 events/hr. Apnea-hypopnea indexes were 38.3 ± 30.6 and 51.9 ± 28.3 events/hr for NREM and REM sleep, respectively. No differences were detected in obstructive respiratory event duration or degree of desaturation between REM and NREM sleep. Additionally, no difference in blood pressure (systolic and diastolic) was detected between REM and NREM sleep during obstructive events and post-obstructive event period. Simple linear regression identified history of hypertension as a predictor of increased systolic blood pressure during obstructive events and post-obstructive event period in both rapid eye movement and non-rapid eye movement sleep. Oxygen desaturation index was also a predictor of increased systolic blood pressure during obstructive events and post-obstructive event period in REM sleep. When obstructive event duration and the degree of desaturation were comparable, no difference in blood pressure was found between REM and NREM sleep during obstructive events and post-obstructive event period.
Highlights
Obstructive sleep apnea (OSA) is a common sleep disorder that occurs during rapid eye movement (REM) and non-REM (NREM) sleep[1]
The findings revealed increased blood pressure (BP) during obstructive events and post-obstructive event period in both REM and non-rapid eye movement (NREM) sleep; the differences in BP between REM and NREM were not statistically significant during the obstructive events or the post-obstructive event period
The obstructive event duration and degree of desaturation were similar in both REM and NREM sleep
Summary
Obstructive sleep apnea (OSA) is a common sleep disorder that occurs during rapid eye movement (REM) and non-REM (NREM) sleep[1]. An earlier study found that the immediate post-apnea period was associated with increased mean arterial pressure, which was preceded by a rise of muscle sympathetic nerve activity[8] none of the studied patients had REM sleep. Most previous studies did not account for obstructive respiratory events duration and the degree of desaturation on BP changes in different sleep stages. We hypothesized that BP during and immediately after obstructive events is higher in REM sleep than in NREM sleep To this end, this study non-invasively assessed BP during and immediately after REM and NREM obstructive events using the PTT-based method
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