Sleep

Abstract

See related article, pp 791–796 Much work has focused on the link between sleep apnea and hypertension, and the evidence that suggests an underlying association between these 2 conditions is persuasive. Sleep apnea syndromes encompass 3 related disorders, obstructive sleep apnea, central sleep apnea, and mixed (or complex) sleep apnea. Obstructive sleep apnea is common, readily diagnosed, and more often than not treatable. Obtaining a thorough sleep history from a patient for symptoms of obstructive sleep apnea, including snoring, witnessed apnea, irregular breathing during sleep, restless sleeping often with choking or gasping arousals, excessive sleepiness, frequent traffic accidents, and declines in cognitive function is now viewed as standard practice. However, obstructive sleep apnea is but one of a number of sleep-related disturbances with the potential for short and more long-term effects on blood pressure (BP).1,2 In that regard, emerging evidence suggests a link between restless legs syndrome (RLS)/periodic limb movements in sleep (PLMS) and hypertension.3–6 RLS is a neurological disorder characterized by pulsating, tugging, creeping, or other unpleasant sensory feelings in the legs and an uncontrollable and sometimes overwhelming urge to shift leg position. In a typical patient, symptoms occur primarily at night as a person might otherwise be relaxing or when one is resting. Symptoms can be present throughout the day, and severity can accentuate during the nighttime hours with leg movement oftentimes relieving the discomfort. The sensations range in severity from simple discomfort to a painful irritation with the integrity of sleep regularly being disrupted. Periodic limb movement disorder …