The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea

Objective Obstructive sleep apnea (OSA) is assumed to influence the circadian blood pressure (BP) fluctuation, particularly causing nocturnal hypertension and changing the dipping pattern of nocturnal BP. This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese...

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Published in:Internal Medicine 2018/06/01, Vol.57(11), pp.1553-1559
Main Authors: Sekizuka, Hiromitsu, Osada, Naohiko, Akashi, Yoshihiro J
Format: Article
Language:English
Subjects:
ambulatory blood pressure monitoring
Angiotensin
Angiotensin II
Angiotensin-converting enzyme inhibitors
Apnea
Blood pressure
circadian rhythm
Circadian rhythms
Dependent variables
Desaturation
Enzyme inhibitors
Health risk assessment
Internal medicine
Multivariate analysis
nocturnal blood pressure
Original
Peptidyl-dipeptidase A
polysomnography
Regression analysis
Risk factors
Sleep
Sleep apnea
Sleep disorders
sleep-disordered breathing
Variation
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container_title Internal Medicine
container_volume 57
creator Sekizuka, Hiromitsu
Osada, Naohiko
Akashi, Yoshihiro J
description Objective Obstructive sleep apnea (OSA) is assumed to influence the circadian blood pressure (BP) fluctuation, particularly causing nocturnal hypertension and changing the dipping pattern of nocturnal BP. This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese patients with severe OSA (the apnea-hypopnea index ≥30/h). Methods Of 541 patients with OSA diagnosed using polysomnography (PSG) and ambulatory BP monitoring (ABPM), 163 patients
doi_str_mv 10.2169/internalmedicine.0029-17
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This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese patients with severe OSA (the apnea-hypopnea index ≥30/h). Methods Of 541 patients with OSA diagnosed using polysomnography (PSG) and ambulatory BP monitoring (ABPM), 163 patients &lt;60 years of age (Younger group) and 101 patients ≥60 years of age (Older group) were stratified into the dipper or non-dipper pattern groups. Results A logistic regression analysis was performed using a non-dipper pattern as a dependent variable. A multivariate analysis demonstrated that the cumulative percentage of time at saturation below 90% was the only independent risk factor for the non-dipper and riser patterns in the Younger group (odds ratio, 1.022; 95% confidence interval, 1.001-1.044; p=0.035), whereas slow-wave sleep (odds ratio, 0.941; 95% confidence interval, 0.891-0.990; p=0.019) and the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio, 2.589; 95% confidence interval, 1.051-6.848; p=0.039) were risk factors in the Older group. Conclusion These findings suggested that the degree of desaturation in young OSA patients and sleep quality in old OSA patients might influence the dipping patterns in nocturnal BP.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.0029-17</identifier><identifier>PMID: 29321408</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>ambulatory blood pressure monitoring ; Angiotensin ; Angiotensin II ; Angiotensin-converting enzyme inhibitors ; Apnea ; Blood pressure ; circadian rhythm ; Circadian rhythms ; Dependent variables ; Desaturation ; Enzyme inhibitors ; Health risk assessment ; Internal medicine ; Multivariate analysis ; nocturnal blood pressure ; Original ; Peptidyl-dipeptidase A ; polysomnography ; Regression analysis ; Risk factors ; Sleep ; Sleep apnea ; Sleep disorders ; sleep-disordered breathing ; Variation</subject><ispartof>Internal Medicine, 2018/06/01, Vol.57(11), pp.1553-1559</ispartof><rights>2018 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2018</rights><rights>Copyright © 2018 by The Japanese Society of Internal Medicine 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-e28f5ec0f37fc11a7a6b784e1f4ed99aedc5908b1c5bb191ced3472eeab71dd93</citedby><cites>FETCH-LOGICAL-c610t-e28f5ec0f37fc11a7a6b784e1f4ed99aedc5908b1c5bb191ced3472eeab71dd93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028665/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028665/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29321408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sekizuka, Hiromitsu</creatorcontrib><creatorcontrib>Osada, Naohiko</creatorcontrib><creatorcontrib>Akashi, Yoshihiro J</creatorcontrib><title>The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective Obstructive sleep apnea (OSA) is assumed to influence the circadian blood pressure (BP) fluctuation, particularly causing nocturnal hypertension and changing the dipping pattern of nocturnal BP. This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese patients with severe OSA (the apnea-hypopnea index ≥30/h). Methods Of 541 patients with OSA diagnosed using polysomnography (PSG) and ambulatory BP monitoring (ABPM), 163 patients &lt;60 years of age (Younger group) and 101 patients ≥60 years of age (Older group) were stratified into the dipper or non-dipper pattern groups. Results A logistic regression analysis was performed using a non-dipper pattern as a dependent variable. A multivariate analysis demonstrated that the cumulative percentage of time at saturation below 90% was the only independent risk factor for the non-dipper and riser patterns in the Younger group (odds ratio, 1.022; 95% confidence interval, 1.001-1.044; p=0.035), whereas slow-wave sleep (odds ratio, 0.941; 95% confidence interval, 0.891-0.990; p=0.019) and the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio, 2.589; 95% confidence interval, 1.051-6.848; p=0.039) were risk factors in the Older group. Conclusion These findings suggested that the degree of desaturation in young OSA patients and sleep quality in old OSA patients might influence the dipping patterns in nocturnal BP.</description><subject>ambulatory blood pressure monitoring</subject><subject>Angiotensin</subject><subject>Angiotensin II</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Apnea</subject><subject>Blood pressure</subject><subject>circadian rhythm</subject><subject>Circadian rhythms</subject><subject>Dependent variables</subject><subject>Desaturation</subject><subject>Enzyme inhibitors</subject><subject>Health risk assessment</subject><subject>Internal medicine</subject><subject>Multivariate analysis</subject><subject>nocturnal blood pressure</subject><subject>Original</subject><subject>Peptidyl-dipeptidase A</subject><subject>polysomnography</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep disorders</subject><subject>sleep-disordered breathing</subject><subject>Variation</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNplkVFv0zAQxyMEYmXwFZAlXnjJ8NlNbL8gVRPbQBNF2ni2HOfSukqdYDtFfHsctVQwXs7S3e_-d-d_URCgVwxq9cH5hMGbfo-ts87jFaVMlSCeFQvgS1UKxqvnxYIqkCXL4aJ4FeOOUi6FYi-LC6Y4gyWViwIft0hujE1DiGTVdWiT8xuScvbr4MvWjSMG8s2keSBxnnwxo_EYcc459CmSny5tyQMeMCBZNzGFKWsckDz0iCNZjR7N6-JFZ_qIb07vZfH95tPj9V15v779fL26L20NNJXIZFehpR0XnQUwwtSNkEuEbomtUgZbWykqG7BV04ACiy1fCoZoGgFtq_hl8fGoO05N_hub9wum12NwexN-6cE4_W_Fu63eDAddUybrusoC708CYfgxYUx676LFvs83D1PUoKSqhOCSZfTdE3Q3TLMpUTNaUQ6qruaN5JGyYYgxYHdeBqievdRPvdSzlxpEbn379zHnxj_mZWB9BHYxmQ2eAROSsz3-r1wJDTDH04gzabcmaPT8NzSuv8M</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Sekizuka, Hiromitsu</creator><creator>Osada, Naohiko</creator><creator>Akashi, Yoshihiro J</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180601</creationdate><title>The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea</title><author>Sekizuka, Hiromitsu ; Osada, Naohiko ; Akashi, Yoshihiro J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-e28f5ec0f37fc11a7a6b784e1f4ed99aedc5908b1c5bb191ced3472eeab71dd93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>ambulatory blood pressure monitoring</topic><topic>Angiotensin</topic><topic>Angiotensin II</topic><topic>Angiotensin-converting enzyme inhibitors</topic><topic>Apnea</topic><topic>Blood pressure</topic><topic>circadian rhythm</topic><topic>Circadian rhythms</topic><topic>Dependent variables</topic><topic>Desaturation</topic><topic>Enzyme inhibitors</topic><topic>Health risk assessment</topic><topic>Internal medicine</topic><topic>Multivariate analysis</topic><topic>nocturnal blood pressure</topic><topic>Original</topic><topic>Peptidyl-dipeptidase A</topic><topic>polysomnography</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep disorders</topic><topic>sleep-disordered breathing</topic><topic>Variation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sekizuka, Hiromitsu</creatorcontrib><creatorcontrib>Osada, Naohiko</creatorcontrib><creatorcontrib>Akashi, Yoshihiro J</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sekizuka, Hiromitsu</au><au>Osada, Naohiko</au><au>Akashi, Yoshihiro J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>57</volume><issue>11</issue><spage>1553</spage><epage>1559</epage><pages>1553-1559</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective Obstructive sleep apnea (OSA) is assumed to influence the circadian blood pressure (BP) fluctuation, particularly causing nocturnal hypertension and changing the dipping pattern of nocturnal BP. This study aimed to clarify the triggers of the non-dipper pattern in nocturnal BP in Japanese patients with severe OSA (the apnea-hypopnea index ≥30/h). Methods Of 541 patients with OSA diagnosed using polysomnography (PSG) and ambulatory BP monitoring (ABPM), 163 patients &lt;60 years of age (Younger group) and 101 patients ≥60 years of age (Older group) were stratified into the dipper or non-dipper pattern groups. Results A logistic regression analysis was performed using a non-dipper pattern as a dependent variable. A multivariate analysis demonstrated that the cumulative percentage of time at saturation below 90% was the only independent risk factor for the non-dipper and riser patterns in the Younger group (odds ratio, 1.022; 95% confidence interval, 1.001-1.044; p=0.035), whereas slow-wave sleep (odds ratio, 0.941; 95% confidence interval, 0.891-0.990; p=0.019) and the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio, 2.589; 95% confidence interval, 1.051-6.848; p=0.039) were risk factors in the Older group. Conclusion These findings suggested that the degree of desaturation in young OSA patients and sleep quality in old OSA patients might influence the dipping patterns in nocturnal BP.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>29321408</pmid><doi>10.2169/internalmedicine.0029-17</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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1349-7235
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subjects ambulatory blood pressure monitoring
Angiotensin
Angiotensin II
Angiotensin-converting enzyme inhibitors
Apnea
Blood pressure
circadian rhythm
Circadian rhythms
Dependent variables
Desaturation
Enzyme inhibitors
Health risk assessment
Internal medicine
Multivariate analysis
nocturnal blood pressure
Original
Peptidyl-dipeptidase A
polysomnography
Regression analysis
Risk factors
Sleep
Sleep apnea
Sleep disorders
sleep-disordered breathing
Variation
title The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea
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