Association Between Arousals During Sleep and Hypertension Among Patients With Obstructive Sleep Apnea

• Published in: Journal of the American Heart Association 2022-01, Vol.11 (1), p.e022141-e022141
• Main Authors: Ren, Rong, Zhang, Ye, Yang, Linghui, Somers, Virend K, Covassin, Naima, Tang, Xiangdong
• Format: Article
• Language: English
• Subjects: Arousal - physiology; high blood pressure; Humans; hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertension - epidemiology; obstructive sleep apnea; Original Research; repetitive arousals; Sleep - physiology; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep Deprivation; sleep fragmentation
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.121.022141

Background Sleep fragmentation induced by repetitive arousals is a hallmark of obstructive sleep apnea (OSA). Sleep fragmentation has been linked to hypertension in community-based studies, but it is unclear if this association is manifest in OSA. We aimed to explore whether frequent arousals from sleep modify the relationship between OSA and prevalent hypertension. Methods and Results A total of 10 102 patients with OSA and 1614 primary snorers were included in the study. Hypertension was defined on either direct blood pressure measures or diagnosis by a physician. Spontaneous, respiratory, and movement arousals were derived by polysomnography. Logistic regression models were used to estimate the associations between arousals and prevalent hypertension in patients with OSA and primary snorers. For every 10-unit increase of total arousal index, odds of hypertension significantly increased in both the total sample (odds ratio [OR], 1.08; 95% CI, 1.03-1.14; =0.002) and patients with OSA (OR, 1.10; 95% CI, 1.04-1.16;