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|Title:||Hypertension is associated with undiagnosed OSA during rapid eye movement sleep|
|Citation:||Chest, 2016; 150(3):495-505|
|Publisher:||American College of Chest Physicians|
|Sarah L. Appleton, Andrew Vakulin, Sean A. Martin, Carol J. Lang, Gary A. Wittert, Anne W. Taylor, R. Doug McEvoy, Nick A. Antic, Peter G. Catcheside and Robert J. Adams|
|Abstract:||BACKGROUND: Evidence linking OSA with hypertension in population studies is conflicting. We examined longitudinal and cross-sectional associations of previously unrecognized OSA, including OSA occurring in rapid eye movement (REM) sleep, with hypertension. METHODS: The Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study is a longitudinal study of community-dwelling men in Adelaide, South Australia. Biomedical assessments at baseline (2002-2006) and follow-up (2007-2010) identified hypertension (systolic $ 140 mm Hg and/or diastolic $ 90 mm Hg, or medication) and risk factors. In 2010 to 2011, 837 men without a prior diagnosis of OSA underwent full in-home unattended polysomnography of whom 739 recorded $ 30 min of REM sleep. Hypertension at follow-up (concomitant with OSA status) was defined as prevalent hypertension. Recentonset hypertension was defined as hypertension at biomedical follow-up (56 months mean follow-up [range, 48-74]) in men free of hypertension at baseline. RESULTS: Severe REM OSA (apnea hypopnea index $30/h) showed independent adjusted associations with prevalent (OR, 2.40, 95% CI, 1.42-4.06), and recent-onset hypertension (2.24 [1.04-4.81]). Significant associations with non-REM AHI were not seen. In men with AHI < 10, REM OSA (apnea hypopnea index) $ 20/h was significantly associated with prevalent hypertension (2.67 [1.33-5.38]) and the relationship with recent-onset hypertension was positive but not statistically significant (2.32 [0.79-6.84]). Similar results were seen when analyses were confined to men with non-REM AHI < 10. CONCLUSIONS: In men not considered to have OSA (AHI < 10), hypertension was associated with OSA during REM sleep. REM OSA may need consideration as an important clinical entity requiring treatment but further systematic assessment and evidence is needed.|
|Keywords:||Epidemiology; hypertension; men; obstructive sleep apnea; rapid eye movement sleep|
|Rights:||Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.|
|Appears in Collections:||Medicine publications|
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