Longitudinal Association of Sleep-Disordered Breathing and ...
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Longitudinal Association of Sleep-Disordered Breathing and ...
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Sleep Disordered Breathing and Nocturnal Blood Pressure
Longitudinal Association of Sleep-Disordered Breathing and Nondipping of Nocturnal Blood Pressure in the Wisconsin Sleep Cohort Study Khin Mae Hla, MD; Terry Young, PhD; Laurel Finn, MS; Paul E. Peppard, PhD; Mariana Szklo-Coxe, PhD; Maryan Stubbs, BS Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Study Objectives: The association of sleep-disordered breathing (SDB) and blunting of normal nocturnal lowering of blood pressure (BP) (nondipping) has only been examined cross-sectionally. The purpose of this study is to investigate whether SDB is prospectively associated with nondipping. Methods: The longitudinal association between SDB and incident nondipping was examined in a subsample of 328 adults enrolled in the Wisconsin Sleep Cohort Study who completed 2 or more 24-hour ambulatory BP studies over an average of 7.2 years of follow-up. SDB identified by baseline in-laboratory polysomnography was defined by apnea-hypopnea index (AHI) categories. Systolic and diastolic nondipping was defined by systolic and diastolic sleep-wake BP ratios > 0.9. All models were adjusted for age, sex, body mass index at baseline and follow-up, smoking, alcohol consumption, hypertension, sleep time, length of follow-up time, and antihypertensive medication use. Results: There was a dose-response increased odds of developing systolic nondipping in participants with SDB. The adjusted odds ratios
(95% confidence interval) of incident systolic nondipping for baseline AHI 5 to < 15 and AHI ≥ 15, versus AHI
