Indian Journal of Sleep Medicine

Register      Login

VOLUME 3 , ISSUE 4 ( October-December, 2008 ) > List of Articles

ORIGINAL ARTICLE

Association of Sleep Disordered Breathing with Systemic hypertension – The Indian perspective

Kavita R. Mody, Amita U. Athavale, Maheema A. Bhaskar, R. Mohan, Kapil Salgia

Keywords : hypertension, sleep disordered breathing, sleep study

Citation Information : Mody KR, Athavale AU, Bhaskar MA, Mohan R, Salgia K. Association of Sleep Disordered Breathing with Systemic hypertension – The Indian perspective. Indian Sleep Med 2008; 3 (4):138-143.

DOI: 10.5005/ijsm-3-4-138

License: CC BY-SA 4.0

Published Online: 01-12-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction : Economic growth, better per capita income and a westernized lifestyle has increased the prevalence of metabolic disorders like hypertension, diabetes, dyslipidemia and obesity in developing countries including India. Sleep Disordered Breathing has been found to be increasingly associated with obesity and hypertension. The incidence and prevalence of SDB in India remains to be fully investigated. In the study an attempt was made to elucidate the true extent and magnitude of association between sleep disordered breathing and hypertension in Indian context. Materials and Methods : 80 patients were enrolled from the Chest Clinic of a tertiary hospital from 2003 till 2005. Patients underwent clinical interview (questionnaire), physical examination, blood pressure measurement and routine investigations. Overnight sleep study was carried out using E series EEG/PSG Compumedics machine (Compumedics, Australia) at the sleep lab. Results : Mean systolic and diastolic blood pressure as well as prevalence of hypertension increased significantly with increasing SDB. High body mass index may be a confounding factor in the analysis. OSAHS has been identified as an independent risk factor for hypertension, with a linear relationship between hypertension and OSAHS. AHI was strongly associated with self reported history of snoring (p=0.007). Conclusion : Our findings suggest that sleep disordered breathing is associated with systemic hypertension in middle and older individuals.


PDF Share
  1. Terry Young, Paul P. Peppard and Daniel J. Gottlieb. Epidemiology of Obstructive Sleep Apnea – A Population Health Perspective. Am J Respir Crit Care Med 2002; 165:1217-1239.
  2. World Health Organization. The Asian Pacific Perspective: Redefining Obesity and its treatment. Health Communications Australia Pty Ltd. February 2000, section 2.
  3. Kales A, Bixler EO, Cadieux RJ, et al. Sleep apnea in a hypertensive population. Lancet 1984 ; 2 :1005-08.
  4. Fletcher EC, De Behnke RD, Lovoi MS, Gorin AB. Undiagnosed sleep apnea in patients with essential hypertension. Ann Intern Med 1985 ; 103 : 190-95.
  5. Williams AJ, Houston D, Finberg S, Lam C, Kinney JL, Santiago S. Sleep apnea syndrome and essential hypertension. Am J Cardiol 1985; 55: 1019-22.
  6. Millman RP, Redline S, Carlisle CC, Assaf AR, Levinson PD. Daytime hypertension in obstructive sleep apnea. Prevalence and contributing risk factors. Chest1991; 99:861-66.
  7. Noda A, Okada T, Hayashi H,Yasuma F, Yokota M.24- hour ambulatory blood pressure variability in obstructive sleep apnea syndrome. Chest1993; 103:1343-47.
  8. Davies CW, Crosby JH, Mullins RL, Barbour C, Davies RJ, Stradling JR. Case-control study for 24 hour ambulatory blood pressure in patients with obstructive sleep apnea and normal matched control subjects. Thorax 2000; 55:736-40.
  9. Nieto FJ,Young TB, Lind BK, et al. Association of sleepdisordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 2000; 283: 1829-36.
  10. Peppard PE, Young T, Palta M, Skaturd J. Prospective study of the association between sleep-disordered breathing and hypertension. NEJM 2000; 342: 1378-84.
  11. Kripke D F, Ancoli Israel S, Klauber M R et al. Prevalence of sleep disordered breathing in age 40-64: a population based survey. Sleep1997; 20: 65-76.
  12. Bixler E, Vgont S A, Ten Hare T et al. Effect of age on sleep Apnea in Men. AJRCCM 1998; 157: 144-148.
  13. Deegan PC, McNicholas WT. Predictive value of clinical features for the obstructive sleep apnea syndrome. Eur Respir J.1996; 9: 117-124.
  14. Stradling JR, Crosby JH, Payne CD. Self reported snoring and daytime sleepiness in man aged 35 to 65 years. Thorax. 1991; 46:807-810.
  15. John B Dixon, Linda M Schachker, Paul E O'Brien. Predicting sleep apnea and EDS in severely obese. Chest; 123-4:1134-1141.
  16. Young T, Palta M, Dempsey J et al. The occurrence of sleep disordered breathing in middle-aged adults. NEJM.1993; 328: 1230-35.
  17. Guilleminault C, Tilkian A, Dement W. The Sleep Apnea syndrome. Ann Rev Med 1976; 27: 465-484.
  18. Stradling TR, Crosby J H. Predictors and prevalence of obstructive sleep Apnea and snoring in 1001 middle aged men. Thorax.1991; 46:85-90.
  19. Wilcox I, McNamara SG, Collins FL, Grunstein RR, Sullivan CE. “Syndrome Z” The interaction of sleep apnoea, vascular risk factors and heart disease. Thorax 1998; 53:S25- S28.
  20. Worsnop CJ, Naughton M T,Barter C E, et al. The prevalence of obstructive sleep apnea in hypertensives. Am J Respir Crit Care Med.1998; 157:111-115.
  21. Carlson JT,Hedner J A,Ejnell H,Peterson L E.High prevalence of hypertension in sleep apnea patients independent of obesity. Am J Respir Crit Care Med.1994; 150:72-77.
  22. Young T, Peppard P, Palta M, et al. Population based study of sleep disordered breathing as a risk factor for hypertension. Arch Intern Med.1997; 157:1746-1752.
  23. Hla KM, T B Young, T.Bidwell, M Palta, J B Skaturd and J Demsey.1994.Sleep apnea and hypertension: a population based study Ann. Intern. Med.120:382-388.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.