hypertension

Does REM-dependent OSA matter? In Hypertension, it does!

Whilst we know that Severe OSA is associated with cardiovascular risk, a significant ‘grey area’ exists. This grey area is where the evidence for cardiovascular risk is less obvious…

OSA is usually worse in REM : it’s a well known phenomenon. REM sleep is associated with more hypotonia (less muscle tone) and your tongue base will be more prone to collapsing… and that will lead to worsening oxygen desaturations (drop in oxygen levels).

When OSA occurs entirely in REM, does it lead to worse health outcomes?

Mokhlesi et al (1) looked at the association between OSA during REM Sleep and Hypertension (high blood pressure). Sleep Data from the Wisconsin Sleep Cohort was analysed, in conjunction with ambulatory blood pressure monitoring.

Those with higher REM-AHI (worse OSA in REM) were more likely to develop hypertension.

OSA outside of REM was not a significant predictor of hypertension.

• Take-home message : REM-dependent OSA is associated with Higher blood pressure issues down the track.

If you have high blood pressure, we’d recommend an in-hospital sleep study. Ring us for an appointment now.

1. Mokhlesi et al. Am J Respir Crit Care Med. 2014.

© APSS 2016

High blood pressure and Sleep Apnoea : an often overlooked link

There are many reasons why someone’s blood pressure may be high, including genetic reasons, dietary reasons, and cardiac reasons. But did you know that one of the most important (and often missed) contributors is Obstructive Sleep Apnea?

The common link between Obstructive Sleep Apnoea (OSA) and Hypertension (high blood pressure) has been known for a long time, and yet we all still overlook this. There is significant literature regarding the link between the two.

More recently, an analysis of the heartBEAT study by Walia et al(1) showed an association between severe untreated Obstructive Sleep Apnea and resistant Hypertension. This was even whilst on blood pressure medications!

They found those with Severe OSA had a 400% higher risk of resistant hypertension. Medications often did not help, unless the OSA was treated.

The messages from this study are simple : Always think about OSA in those with hypertension, always exclude OSA first…

 

Key points :

•  OSA is a recognized major contributor to Hypertension
•  On more than 2 antihypertensives… think OSA!
•  Not responding to blood pressure medications… think OSA!
•  OSA increases risk of treatment-resistant hypertension by 4x

 

Our Adelaide sleep doctors can consult you, perform and report your sleep study, and your Adelaide sleep specialist will commence you on treatment. Give our Adelaide sleep clinic a call now.

1. Walia et al. J Clin Sleep Med. 2014;10:835-843

© APSS 2014