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CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(02): 197-205
DOI: 10.1055/s-0043-1770797
Original Article

Is it Mandatory to do a 24 hour ABPM in all Patients with Moderate to Severe Obstructive Sleep Apnoea?

Autoren

  • Edgar D. Osuna 

    1   Department of Neurology, Fundación Santafé de Bogotá, Bogotá, Colombia
    2   School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia

  • Adrián C. Zamora 

    1   Department of Neurology, Fundación Santafé de Bogotá, Bogotá, Colombia

  • Andrés F. Buitrago

    3   Department of Cardiology, Fudación Santafé de Bogotá, Bogotá, Colombia

  • Jaime F. Salazar

    4   Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia

  • Santiago A. Rosales

    4   Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia

  • Camila Galeano

    4   Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia

  • Yuli Guzman-Prado

    4   Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia

  • Carolina Ferreira-Atuesta

    4   Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
    5   Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Abstract

Background Obstructive sleep apnoea (OSA) has been described as a risk factor for arterial hypertension (HT). One of the proposed mechanisms linking these conditions is non dipping (ND) pattern in nocturnal blood pressure, however evidence is variable and based on specific populations with underlying conditions. Data for OSA and ND in subjects residing at high altitude are currently unavailable.

Objective Identify the prevalence and association of moderate to severe OSA with HT and ND pattern in hypertensive and non-hypertensive otherwise healthy middle-aged individuals in residing at high altitude (Bogotá:2640 mt)

Methods Adult individuals with diagnosis of moderate to severe OSA underwent 24 hour- ambulatory blood pressure monitoring (ABPM) between 2015 and 2017. Univariable and multivariable logistic regression analysis were performed to identify predictors of HT and ND pattern.

Results Ninety-three (93) individuals (male 62.4% and median age 55) were included in the final analysis. Overall, 30.1% showed a ND pattern in ABPM and 14.9% had diurnal and nocturnal hypertension. Severe OSA (higher apnea-hiponea index [AHI]) was associated with HT (p = 0.006), but not with ND patterns (p = 0.54) in multivariable regression. Smoking status and lowest oxygen saturation during respiratory events where independently associated with ND pattern (p = 0.04), whereas age (p = 0.001) was associated with HT.

Conclusions In our sample, one in three individuals with moderate to severe OSA have non dipping patterns suggesting lack of straight association between OSA and ND. Older individuals who have higher AHI are more likely to have HT, and those who smoke have a higher risk of ND. These findings add aditional information to the multiple mechanisms involved in the relationship between OSA and ND pattern, and questions the routine use of 24-hour ABPM, particullary in our region, with limited resources and healthcare acces. However, further work with more robust methodology is needed to draw conclusions.

Keywords

obstructive sleep apnoea - ambulatory monitoring - blood pressure - hypertension - non-dipping - nocturnal hypertension


Publikationsverlauf

Artikel online veröffentlicht:
06. Juli 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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