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KMID : 1101420160480030255
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Korean Journal of Clinical Laboratory Science
2016 Volume.48 No. 3 p.255 ~ p.261
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The Association between Excessive Daytime Sleepiness and Blood Pressure in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome
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Kim Cheon-Sik
Kim Dae-Sik
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Abstract
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The purpose of this study was to investigate the relationship between excessive daytime sleepiness (EDS) and blood pressure (BP) in patients with obstructive sleep apnea-hypopnea (OSAH). Patients were classified into four groups based on their severity of polysomnographic data: the snoring group (n=108)?characterized by Apnea-Hypopnea Index (AHI<5); the mild OSA group (n=186)?AHI 5≤AHI<15; the moderate OSA group (n=179)? AHI 15≤AHI<30; and the severe OSA group (n=233)?AHI≥30. On the same night of polysomnography (PSG), BP levels were measured before sleeping (bedtime BP) and immediately after waking up on the following morning (morning BP). EDS was recognized as ESS (epworth sleepiness scale)≥9. The differences and correlations between BP and PSG parameters in the EDS and non-EDS groups of OSAH patients were analyzed. MAP was positively correlated with BMI, AHI, and total arousal (r=0.099, r=0.142, r=0.135, p<0.01, p<0.01, p<0.01), while negatively correlated with mean SaO2 (r=?0.258, p< 0.01). The EDS group had overall younger population (47.2±11.3 vs 50.3±11.4, p=0.023), higher DBP (both bedtime and morning, 83.1±9.7 vs 81.4±8.8 and 86.4±9.2 vs 83.6±9.7)(p=0.031, p=0.047), and higher SBP (both bedtime and morning, 126.7±11.2 vs 123.4±12.4, 128.9±12.4 vs 125.3±12.9)(p=0.021, p=0.021) than compared with the non-EDS group. In hypertensive OSAH patients, patients with EDS were also younger and had higher total arousal number, as well as higher morning and bedtime DBP and SBP than compared with the non-EDS group (p<0.005, p=0.008, p<0.001 and p<0.001). EDS in OSAHS patients is a special phenotype characterized by younger age, higher DBP, more severe desaturation, and hypertension.
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KEYWORD
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Excessive daytime sleepiness, Obstructive sleep apnea hypopnea, Epworth sleepiness scale, Blood pressure
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