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Sleep disordered breathing and hypertension: does self-reported sleepiness modify the association?
Tuesday,2012-11-06 12:10 America/Los_Angeles — eenright
| Title | Sleep disordered breathing and hypertension: does self-reported sleepiness modify the association? |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Kapur, VK, Resnick, HE, Gottlieb, DJ |
| Corporate/Institutional Authors | Sleep Heart Health Study Group, |
| Journal | Sleep |
| Volume | 31 |
| Issue | 8 |
| Pagination | 1127-32 |
| Date Published | 2008 Aug |
| ISSN | 0161-8105 |
| Keywords | Aged, Antihypertensive Agents, Comorbidity, Cross-Sectional Studies, Disorders of Excessive Somnolence, Female, Health Surveys, Humans, Hypertension, Male, Middle Aged, Odds Ratio, Oxygen, Polysomnography, Sleep Apnea, Obstructive, United States |
| Abstract | <p><b>STUDY OBJECTIVES: </b>Epidemiologic studies that demonstrate increased risk of hypertension in persons with sleep disordered breathing indicate that only a minority of these persons report significant subjective sleepiness. Studies also suggest that presence of self-reported sleepiness may identify a subset of persons with sleep disordered breathing who are at greatest risk of cardiovascular sequelae, including hypertension. We explore whether self-reported sleepiness modifies the relationship between sleep disordered breathing and prevalent hypertension.</p><p><b>DESIGN: </b>Cross-sectional.</p><p><b>SETTING: </b>Multicenter study.</p><p><b>PARTICIPANTS: </b>6046 subjects from the Sleep Heart Health Study.</p><p><b>MEASUREMENTS: </b>Polysomnography, systolic and diastolic blood pressure, antihypertensive medication use, questionnaire determined excessive sleepiness and Epworth Sleepiness Scale, and covariates.</p><p><b>RESULTS: </b>The odds of hypertension at higher apnea hypopnea index categories were larger in participants identified as sleepy based on responses to a frequency of sleepiness question or the Epworth score. For example, for those with AHI > or =30 compared to AHI <1.5, the adjusted odds ratio for hypertension was 2.83 (1.33-6.04) among those reporting sleepiness > or =5 days per month, but only 1.22 (0.89-1.68) among those reporting less frequent daytime sleepiness. In adjusted logistic regression models, there was statistical evidence for effect modification by frequency of sleepiness (P = 0.033) of the association between apnea hypopnea index and hypertension. In adjusted models that included the Epworth score as a continuous variable, the interaction term fell slightly short of statistical significance (beta = 0.010, P = 0.07).</p><p><b>CONCLUSION: </b>This study finds that the association of sleep disordered breathing with hypertension is stronger in individuals who report daytime sleepiness than in those who do not.</p> |
| Alternate Journal | Sleep |
| PubMed ID | 18714785 |
| PubMed Central ID | PMC2542959 |
| Grant List | U01HL53937 / HL / NHLBI NIH HHS / United States U01 HL053916 / HL / NHLBI NIH HHS / United States U01HL64360 / HL / NHLBI NIH HHS / United States U01 HL063463 / HL / NHLBI NIH HHS / United States U01HL53938 / HL / NHLBI NIH HHS / United States U01 HL053938 / HL / NHLBI NIH HHS / United States U01HL53934 / HL / NHLBI NIH HHS / United States U01 HL064360 / HL / NHLBI NIH HHS / United States U01 HL053941 / HL / NHLBI NIH HHS / United States U01HL63429 / HL / NHLBI NIH HHS / United States U01HL53931 / HL / NHLBI NIH HHS / United States U01HL53941 / HL / NHLBI NIH HHS / United States U01 HL053934 / HL / NHLBI NIH HHS / United States U01HL53916 / HL / NHLBI NIH HHS / United States U01 HL063429 / HL / NHLBI NIH HHS / United States U01 HL053937 / HL / NHLBI NIH HHS / United States U01HL53940 / HL / NHLBI NIH HHS / United States U01HL63463 / HL / NHLBI NIH HHS / United States U01 HL053931 / HL / NHLBI NIH HHS / United States |