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Clinical InvestigationsSystemic Hypertension in Snorers with and without Sleep Apnea
Section snippets
MATERIALS AND METHODS
We studied 191 men aged 49.9 ±0.8 years. All of them had a history of loud snoring, which was the main reason for referral to the sleep laboratory in 84 of them. Apneas observed by their bed partners were reported by 115 of them, and 103 complained about excessive daytime sleepiness. A history of involuntarily falling asleep during the day was found in 116. All but 27 patients were above normal weight, ie, their body mass index (BMI) was higher than 25. Mean BMI of our study population was 29.6
RESULTS
In 116 of the 191 male snorers, an AHI above 10 was found, which was defined as the presence of OSA. The remaining 75 men with an AHI below 10 were classified as HSN. Mean AHI was 36.7±2.1 in the OSA group and 3.6 ±0.3 in the HSN group. The two groups did not differ in age (50.3 ±1 vs 49.3 ±1.2; p = 0.52), but OSA patients were more obese than the HSN group (BMI: 30.4 ±0.5 vs 28.5 ±0.6; p = 0.011).
A total of 102 subjects had neither elevated BP on examination nor a history of HT or
DISCUSSION
This study shows that daytime hypertension in male snorers does not depend on the occurrence of apneas during sleep. As we found equal prevalences of HT in snorers with AHI >10 and snorers with AHI <10 (48 percent vs 44 percent), our results do not support the hypothesis of a direct link between sleep apnea and hypertension. If OSA causes HT, one would expect that patients with more severe OSA are more prone to develop HT or show higher BPs than those with mild disease or only simple snoring,
REFERENCES (30)
- et al.
Prevalence of sleep apnea syndrome among Swedish men—an epidemiological study
J Clin Epidemiol
(1988) - et al.
Prevalence of sleep apnea syndrome among patients with hypertension
Am Heart J
(1984) - et al.
Sleep apnea in a hypertensive population
Lancet
(1984) - et al.
Sleep apnea syndromes and essential hypertension
Am J Cardiol
(1985) - et al.
Determinants of blood pressure in snorers
Lancet
(1988) - et al.
Systemic hypertension in sleep apnea syndrome —relationship with sleep architecture and breathing abnormalities
Chest
(1990) The sympathetic nervous system in clinical and experimental hypertension
Kidney Int
(1986)- et al.
Snoring, I: daytime sleepiness in regular heavy snorers
Chest
(1991) - et al.
Daytime hypertension in obstructive sleep apnea: prevalence and contributing risk factors
Chest
(1991) - et al.
Hemodynamics in sleep-induced apnea studies during wakefulness and sleep
Ann Intern Med
(1976)
Clinical overview of the sleep apnea syndromes
The hypersomnia-sleep apnea syndrome: a reversible major cardiovascular hazard
Circulation
Breathing during sleep in man in normal and pathological conditions
Adv Exp Med Biol
Undiagnosed sleep apnea in patients with essential hypertension
Ann Intern Med
Hemodynamic changes during sleep
J Appl Physiol
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Epidemiology of sleep disorders
2011, Handbook of Clinical NeurologyCitation Excerpt :Unfortunately a good clinical history and clinical examination are sometimes overlooked, trusting too much the results of sleep recordings. Heavy habitual (every night) snoring (i.e., partial upper-airway obstruction), even without apneas, may influence pulmonary arterial pressure, and it is associated with daytime sleepiness, arterial hypertension, insulin resistance, metabolic syndrome and other health consequences (Lugaresi et al., 1975, 1983b; Partinen et al., 1983b, 1998; Koskenvuo et al., 1985b; Rauscher et al., 1992; Tiihonen et al., 1993; Martikainen et al., 1994; Grunstein et al., 1995; Grunstein, 1996; Young et al., 1996, 1997; Fuyuno et al., 1999; Hu et al., 1999, 2000; Bixler et al., 2000; Franklin et al., 2000; Lavie et al., 2000; Peppard et al., 2000; Leineweber et al., 2003). Sleep-related breathing disorders (SRBD) and sleep-disordered breathing (SDB) refer mostly to sleep apnea.
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2008, Sleep Medicine ClinicsCitation Excerpt :Treatment of OSA with CPAP can reduce leptin levels, central obesity, insulin resistance, and hypertension [51,64,65]. Hypertension is found in up to 40% of apneics [66,67]. SDB has been shown to be a risk factor for developing hypertension.
Manuscript received July 18; revision accepted November 8.