Asleep home blood pressure monitoring in obstructive sleep apnea

Abstract

In patients with OSA, the assessment of night-time BP using a home monitor appears to be feasible and related to the severity of OSA. Given the wide availability of home BP monitoring in clinical practice, this method appears to be useful in the evaluation of BP in patients with OSA.

The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

“…Moreover, the timing of administering antihypertensive medication may be changed to the evening in nondipper patients with refractory hypertension to improve BP control (Almirall, Comas, Martínez-Ocañ a, Roca, & Arnau, 2012). Considering that CPAP therapy was shown to be effective in preventing the transitory increase in BP in patients with OSAHS (Stergiou et al, 2013), nurses should take necessary measures such as stage-matched intervention to improve CPAP adherence (Deng, Wang, Sun, & Chen, 2013). To improve self-care behaviors, we suggest that nurses provide face-to-face counseling and regular telephone follow-up with the patients to stress the importance of vigilance in BP monitoring using a home BP monitor and BP diaries, suggest strategies to improve medication adherence, provide instructions to patients on how to read food labels on foods to better monitor salt and fat intake, and conduct health education on reducing smoking and alcohol consumption (Hebert et al, 2012).…”

“…Similar to our results, Stergiou et al confirmed that an increase in AHI at night promoted an absence of nocturnal dipping and a significant increase in urinary catecholamine levels. Furthermore, continuous positive airway pressure (CPAP) therapy was shown to be effective in preventing the transitory increase in BP (Stergiou et al, 2013). CPAP resulted in significant improvements in 24-hour urinary norepinephrine levels and BP in patients with severe OSAHS (Pinto et al, 2013).…”

Night-time home versus ambulatory blood pressure in determining target organ damage

“…In 2001, Chonan et al [6] published the first data on an HBP monitor (Omron HEM 747-IC-N, Omron Life Science Co., Tokyo, Japan) capable to obtain automated BP measurement during night-time sleep, and several other studies confirmed the feasibility of the method, in most cases applied for three consecutive nights [6][7][8][9][10][11][12]. The present study showed slightly higher daytime and nighttime values with HBP compared with ABP monitoring, which reached statistical significance.…”

“…Although ABP is regarded as a unique tool for the evaluation of night-time BP, novel HBP monitors have been developed which also have the capacity to obtain BP measurements during night-time sleep [6][7][8][9][10][11][12]. Preliminary data showed that the evaluation of night-time BP is feasible and reproducible with these HBP monitors [6][7][8] and a cross-sectional study in untreated and treated hypertensives showed good agreement between the two methods in detecting nondippers [9].…”

Home blood pressure monitoring

“…The 24-ABPM offers some advantages beyond home BP, such as more detailed identification of morning BP surge, short-term BP variability and nocturnal hypertension or ‘non-dipping’ BP patterns in which prognosis is worse [ 16 , 17 ]. It is possible to also measure night-time BP using some home BP devices, which provide night-time BP values comparable to 24-ABPM [ 18 – 21 ]. BP measured with home BP has also been shown to have good correlation with daytime 24-ABPM [ 22 ].…”