Cumulative association of OSA severity and sleep dept with hypertension

Aims:Obstructive sleep apnea (OSA) and short sleep duration are both individually associated with an increased risk for hypertension (HTN). The aim of this multicenter cross-sectional study was to test the hypothesis of a cumulative association of OSA severity and short sleep duration with the risk for HTN. Methods and results: In 2,270 patients undergoing polysomnography for suspected OSA, HTN was defined by systolic blood pressure (BP)≥140 mmHg and/or diastolic BP≥90 mmHg, and/or the use of antihypertensive treatment. Patients with total sleep time (TST)<6h were considered to be short sleepers. OSA was defined by an apnea-hypopnea index (AHI)≥5. Logistic regression procedures were performed to determine the independent association of HTN with OSA and sleep duration. After adjustment for demographics, anthropometric variables, diabetes, alcohol intake, smoking, daytime sleepiness, sleep architecture and fragmentation, and study site, OSA and short sleep duration were individually associated with a significant higher risk for HTN (p<0.0001 for both). Considering normal sleepers (TST≥6h) without OSA as the reference group, the risk for HTN appeared to present a cumulative association with OSA severity and short sleep duration after adjustment for confounders (p<0.0001 for linear trend). The higher risk for HTN was observed in patients with both severe OSA (AHI≥30) and short sleep duration (odds ratio: 2.851, 95% confidence interval, 1.820-4.467). Conclusion: OSA and short sleep duration have a cumulative association with the risk for HTN. Further studies are required to determine whether interventions to optimize sleep may contribute to lower BP in patients with OSA.