PT  - JOURNAL ARTICLE
AU  - Babak Mokhlesi
AU  - Erika W Hagen
AU  - Laurel A Finn
AU  - Khin Mae Hla
AU  - Jason R Carter
AU  - Paul E Peppard
TI  - Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: a longitudinal analysis of the Wisconsin Sleep Cohort
AID  - 10.1136/thoraxjnl-2015-207231
DP  - 2015 Nov 01
TA  - Thorax
PG  - 1062--1069
VI  - 70
IP  - 11
4099  - http://thorax.bmj.com/content/70/11/1062.short
4100  - http://thorax.bmj.com/content/70/11/1062.full
SO  - Thorax2015 Nov 01; 70
AB  - 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–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.