title: [Increased daytime tiredness, nocturnal hypertension and sleep apnea: studies in rural general practice].
abstract: Studies in a Rural General Practice: Sleep-Related Breathing Disorders (SRBD) and altered circadian blood pressure profile are related to increased cardiovascular risk. We investigated the prevalence and coincidence of both diseases in male patients from a general practice in a small community of 2500 people. Out of 409 selected patients (using a questionnaire regarding symptoms and findings of SRBD), 185 were monitored in an outpatient setting with an apnoea-screening system Mesam IV. Ambulatory blood pressure monitoring (Spacelabs 90207). Holter-ECG and actigraphy were also measured. Sixty patients had a Respiratory Disturbance Index (RDI) > 10. An indication for further sleep studies was seen in 40 patients; 36.5% of daytime hypertensives were "Non-Dipper", and 47.6% of normotensives were also "Non-Dipper". Excessive daytime sleepiness (EDS) is an important symptom of SRBD, and in this investigation we noticed a large number of patients without this symptom suffering from relevant SRBD. Therefore, absence of EDS alone is not indicative for the use of ambulatory monitoring.
authors.affiliation: Medizinische Poliklinik, Klinikum der Philipps-Universität Marburg.
authors.forename: L
authors.initials: L
authors.lastname: Grote
authors.forename: H
authors.initials: H
authors.lastname: Schneider
authors.forename: T
authors.initials: T
authors.lastname: Ploch
authors.forename: T
authors.initials: T
authors.lastname: Penzel
authors.forename: J H
authors.initials: JH
authors.lastname: Peter
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D003430:Cross-Sectional Studies; D005194:Family Practice; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology