Jennifer Gehring1, Heiko Gesche2, Gesine Drewniok3, Gert Küchler1, Andreas Patzak4. 1. SOMNOmedics GmbH, Randersacker, Germany. 2. Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. 3. Klinik Amsee, Schlaflabor, Waren, Germany. 4. Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. andreas.patzak@charite.de.
Abstract
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is related to arterial hypertension. In the present study, we test the hypothesis that patients with severe OSAS have excessive apnea induced blood pressure (BP). METHODS: We investigated 97 patients with an apnea/hypopnea index (AHI) greater than 30. Systolic BP (SBP) was continuously determined by using the pulse transit time (PTT). Apnea/hypopnea induced nocturnal BP fluctuations (NBPFs) were detected and showed phenomena of continuous increases of the SBP baseline. Such periods of SBP baseline elevations ≥ 10 mmHg were called superposition. Respiratory and cardiac parameters were obtained from the polysomnographic investigation. RESULTS: Eighty-four periods of superposition were detected in 48 patients. They occurred mainly during REM sleep (76%). Apnea duration was increased and the time in respiration was reduced in periods of superposition compared to non-superposition periods. In superposition periods mean oxygen saturation (SpO2) and the minimal SpO2 were lower, desaturations were more pronounced, and the mean heart rate (HR) was increased. The maximum SBP during superposition was significantly increased (204 ± 32 vs.171 ± 28 mmHg). The clinic BP was higher in patients with superposition (SBP 149.2 ± 17.5 vs. 140 ± 19.1, DBP 91.5 ± 11.5 vs. 86.3 ± 11.8). CONCLUSIONS: The study reveals that patients with severe OSAS can have periods of BP superposition during night with extremely high SBP and very low oxygen saturation, which may add to a high risk for cardiovascular events during the night.
BACKGROUND:Obstructive sleep apnea syndrome (OSAS) is related to arterial hypertension. In the present study, we test the hypothesis that patients with severe OSAS have excessive apnea induced blood pressure (BP). METHODS: We investigated 97 patients with an apnea/hypopnea index (AHI) greater than 30. Systolic BP (SBP) was continuously determined by using the pulse transit time (PTT). Apnea/hypopnea induced nocturnal BP fluctuations (NBPFs) were detected and showed phenomena of continuous increases of the SBP baseline. Such periods of SBP baseline elevations ≥ 10 mmHg were called superposition. Respiratory and cardiac parameters were obtained from the polysomnographic investigation. RESULTS: Eighty-four periods of superposition were detected in 48 patients. They occurred mainly during REM sleep (76%). Apnea duration was increased and the time in respiration was reduced in periods of superposition compared to non-superposition periods. In superposition periods mean oxygen saturation (SpO2) and the minimal SpO2 were lower, desaturations were more pronounced, and the mean heart rate (HR) was increased. The maximum SBP during superposition was significantly increased (204 ± 32 vs.171 ± 28 mmHg). The clinic BP was higher in patients with superposition (SBP 149.2 ± 17.5 vs. 140 ± 19.1, DBP 91.5 ± 11.5 vs. 86.3 ± 11.8). CONCLUSIONS: The study reveals that patients with severe OSAS can have periods of BP superposition during night with extremely high SBP and very low oxygen saturation, which may add to a high risk for cardiovascular events during the night.
Authors: V Aboyans; C Cassat; P Lacroix; P Tapie; F Tabaraud; F Pesteil; F Bertin; M Laskar; P Virot Journal: Cardiology Date: 2000 Impact factor: 1.869
Authors: Gianfranco Parati; Carolina Lombardi; Jan Hedner; Maria R Bonsignore; Ludger Grote; Ruzena Tkacova; Patrick Levy; Renata Riha; Claudio Bassetti; Krzysztof Narkiewicz; Giuseppe Mancia; Walter T McNicholas Journal: J Hypertens Date: 2012-04 Impact factor: 4.844
Authors: Lorenzo Loffredo; Anna Maria Zicari; Francesca Occasi; Ludovica Perri; Roberto Carnevale; Francesco Angelico; Maria Del Ben; Francesco Martino; Cristina Nocella; Vincenzo Savastano; Azzurra Cesoni Marcelli; Marzia Duse; Francesco Violi Journal: Atherosclerosis Date: 2015-03-18 Impact factor: 5.162
Authors: A G Logan; S M Perlikowski; A Mente; A Tisler; R Tkacova; M Niroumand; R S Leung; T D Bradley Journal: J Hypertens Date: 2001-12 Impact factor: 4.844
Authors: Carmen M Troncoso Brindeiro; Ana Q da Silva; Kyan J Allahdadi; Victoria Youngblood; Nancy L Kanagy Journal: Am J Physiol Heart Circ Physiol Date: 2007-08-31 Impact factor: 4.733
Authors: Giovanna E Carpagnano; Sergei A Kharitonov; Onofrio Resta; Maria P Foschino-Barbaro; Enzo Gramiccioni; Peter J Barnes Journal: Chest Date: 2003-10 Impact factor: 9.410
Authors: Diego R Mazzotti; Diane C Lim; Kate Sutherland; Lia Bittencourt; Jesse W Mindel; Ulysses Magalang; Allan I Pack; Philip de Chazal; Thomas Penzel Journal: Physiol Meas Date: 2018-09-13 Impact factor: 2.833
Authors: Younghoon Kwon; Patrick L Stafford; Diane C Lim; Sungha Park; Sung-Hoon Kim; Richard B Berry; David A Calhoun Journal: Blood Press Monit Date: 2020-04 Impact factor: 1.430
Authors: Younghoon Kwon; Christopher Wiles; B Eugene Parker; Brian R Clark; Min-Woong Sohn; Sara Mariani; Jin-Oh Hahn; David R Jacobs; James H Stein; Joao Lima; Vishesh Kapur; Andrew Wellman; Susan Redline; Ali Azarbarzin Journal: Thorax Date: 2021-04-16 Impact factor: 9.102
Authors: Frauke Picard; Petroula Panagiotidou; Anne-Beke Tammen; Anamaria Wolf-Pütz; Maximilian Steffen; Hanno Julian Gerhardy; Sebastian Waßenberg; Rolf Michael Klein Journal: J Clin Sleep Med Date: 2022-02-01 Impact factor: 4.062