Nocturnal Blood Pressure Fluctuations in Patients with Rapid Eye Movement-Related Obstructive Sleep Apnea

Abstract

Rapid eye movement-related obstructive sleep apnea (REM-related OSA) is a polysomnographic phenotype. Nocturnal blood pressure (BP) fluctuations remain unclear in patients with REM-related OSA. We studied 27 patients with REM-related OSA, categorized as having REM-apnea-hypopnea index (REM-AHI) ≥ 5/h, REM-AHI/non-REM-AHI ≥ 2, and non-REM-AHI < 15/h. Beat-to-beat systolic BP (SBP) variability and nocturnal SBP fluctuation patterns using pulse transit time (PTT) were investigated. The maximum increase and average nocturnal SBP were significantly higher in males than in females (p = 0.003 and p = 0.008, respectively). The rate of non-dipping patterns in nocturnal SBP fluctuations was 63% in all patients (males, 70%; females, 50%). Epworth Sleepiness Scale (ESS) and Self-rating Depression Scale (SDS) scores in females were higher than those in males (8.4 ± 6.1 vs. 13.4 ± 5.4 points, p = 0.04; 43.8 ± 7.9 vs. 52 ± 11.6 points, p = 0.04, respectively). A high proportion of patients with REM-related OSA had a non-dipping pattern. Using PPT, we observed that in patients with REM-related OSA, SBP variability was greater in males. Despite clinical symptoms being slightly more severe in females, nocturnal SBP fluctuations should be considered in male patients with REM-related OSA.

Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea

“…PTT is a well-established method for measuring BP. Significantly high correlations between BP measurements obtained using oscillometric and PTT-based methods have also been reported, which have confirmed the efficacy of PTT [ 17 , 18 , 19 , 20 , 21 ]. PTT-BP (i.e., BP obtained using PTT) has several advantages over 24 h ambulatory BP monitoring, such as noninvasive cuff-less measurement that does not disturb sleep, availability of beat-to-beat BP calculation and beat-to-beat BPF analysis, and detailed monitoring during sleep through continuous recording of beat-to-beat NBPFs.…”

Effects of continuous positive airway pressure therapy on nocturnal blood pressure fluctuation patterns in patients with obstructive sleep apnea

“…Significantly high correlations between BP measurements obtained using oscillometric and PTT-based methods have also been reported, which proved the efficacy of PTT [15][16][17][18][19]. PTT-BP, i.e., BP obtained using PTT, has several advantages over 24-h ambulatory BP monitoring, such as: (i) noninvasive cuff-less measurement that does not disturb sleep, (ii) availability of beat-to-beat BP calculation and short-term BPF analysis, and (iii) detailed monitoring during sleep by continuous recording of short-term NBPFs.…”