@article {Mokhlesi1062, author = {Babak Mokhlesi and Erika W Hagen and Laurel A Finn and Khin Mae Hla and Jason R Carter and Paul E Peppard}, title = {Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: a longitudinal analysis of the Wisconsin Sleep Cohort}, volume = {70}, number = {11}, pages = {1062--1069}, year = {2015}, doi = {10.1136/thoraxjnl-2015-207231}, publisher = {BMJ Publishing Group Ltd}, abstract = {Background Non-dipping of nocturnal blood pressure (BP) is associated with target organ damage and cardiovascular disease. Obstructive sleep apnoea (OSA) is associated with incident non-dipping. However, the relationship between disordered breathing during rapid eye movement (REM) sleep and the risk of developing non-dipping has not been examined. This study investigates whether OSA during REM sleep is associated with incident non-dipping.Methods Our sample included 269 adults enrolled in the Wisconsin Sleep Cohort Study who completed two or more 24 h ambulatory BP studies over an average of 6.6 years of follow-up. After excluding participants with prevalent non-dipping BP or antihypertensive use at baseline, there were 199 and 215 participants available for longitudinal analysis of systolic and diastolic non-dipping, respectively. OSA in REM and non-REM sleep were defined by apnoea hypopnoea index (AHI) from baseline in-laboratory polysomnograms. Systolic and diastolic non-dipping were defined by systolic and diastolic sleep/wake BP ratios \>0.9. Modified Poisson regression models estimated the relative risks for the relationship between REM AHI and incident non-dipping, adjusting for non-REM AHI and other covariates.Results There was a dose{\textendash}response greater risk of developing systolic and diastolic non-dipping BP with greater severity of OSA in REM sleep (p-trend=0.021 for systolic and 0.024 for diastolic non-dipping). Relative to those with REM AHI\<1 event/h, those with REM AHI>=15 had higher relative risk of incident systolic non-dipping (2.84, 95\% CI 1.10 to 7.29) and incident diastolic non-dipping (4.27, 95\% CI 1.20 to 15.13).Conclusions Our findings indicate that in a population-based sample, REM OSA is independently associated with incident non-dipping of BP.}, issn = {0040-6376}, URL = {https://thorax.bmj.com/content/70/11/1062}, eprint = {https://thorax.bmj.com/content/70/11/1062.full.pdf}, journal = {Thorax} }