Nature and Science of Sleep (Jul 2022)

High Rapid Eye Movement Sleep Apnea Hypopnea Index is Associated with Hypertension in Patients with Obstructive Sleep Apnea

  • Wang L,
  • Wei D,
  • Zhang J,
  • Cao J,
  • Zhang X

Journal volume & issue
Vol. Volume 14
pp. 1249 – 1258

Abstract

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Le Wang,1 Donghui Wei,1 Jing Zhang,1 Jie Cao,1 Xinxin Zhang2 1Department of Respiratory and Critical Care, Tianjin Medical University General Hospital, Tianjin, The People’s Republic of China; 2Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, The People’s Republic of ChinaCorrespondence: Jing Zhang; Jie Cao, Department of Respiratory and Critical Care, Tianjin Medical University General Hospital, Tianjin, 300052, The People’s Republic of China, Tel +86 02260361612 ; Tel +86 02260361612, Email [email protected]; [email protected]: Obstructive sleep apnea (OSA) plays an important role in the pathogenesis of hypertension. The aim of this cross-sectional study was to explore the clinical and polysomnographic characteristics of OSA patients with hypertension and to explore the gender differences in the relationship between rapid eye movement (REM) OSA and hypertension.Patients and Methods: A total of 808 patients with OSA at a tertiary hospital were enrolled in this study, and OSA patients were divided into groups presenting with or without hypertension. The clinical and polysomnographic characteristics were compared between the groups. Multivariate binary logistic analysis was performed to assess the association between REM OSA and hypertension.Results: After adjustment for potential confounders, the risk of hypertension in patients with OSA increased with severity categories of apnea hypopnea index during rapid eye movement sleep stage (REM AHI) (OR = 1.61 for REM AHI ≥ 58.87 events/h relative to REM AHI < 30.50 events/h, 95% CI 1.07– 2.42, P = 0.022). Consistent with this, when taken as a continuous variable, this association still remains significant (OR = 1.007, 95% CI 1.001– 1.014, P < 0.05). This effect was more pronounced in women patients, the OR for REM AHI ≥ 57.24 events/h relative to REM AHI < 30.36 events/h was 2.79 (95% CI, 1.16– 6.73; P = 0.022); however, there was no significant difference in male patients.Conclusion: REM AHI was significantly and positively associated with hypertension in patients with OSA, and the effect was more pronounced in female patients.Keywords: hypertension, obstructive sleep apnea, apnea hypopnea index during rapid eye movement sleep, risk factor

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