title: Obstructive sleep apnea syndrome.
abstract: Obstructive sleep apnea syndrome is caused by upper airway collapse during inspiration, causing intermittent hypoxemia, hypercapnia, acidosis, sympathetic nervous system activation, and arousal from sleep. Nighttime blood pressure is higher, but unexpectedly, daytime hypertension occurs. The prevalence of hypertension is very high and the incidence of hypertension increases as the number of apneic and hypopneic events per hour rises. Obesity is a major predisposing factor for the development of obstructive sleep apnea. Daytime sleepiness, snoring, and breathing pauses are important symptoms to elicit from the patient or sleep partner. Resistant hypertension is an important clue. Overnight polysomnography is required for diagnosis. Weight loss, avoidance of nocturnal sedatives, cessation of evening alcohol ingestion, and avoidance of the supine position during sleep are initial therapeutic actions in mild obstructive sleep apnea syndrome. Continuous positive airway pressure is the treatment of choice for patients unable to find relief from lifestyle changes. Blood pressure modestly improves with treatment.
authors.affiliation: Departments of Medicine, Medical College of Georgia, Augusta, GA 30912, USA. mprisant@mcg.edu
authors.forename: L Michael
authors.initials: LM
authors.lastname: Prisant
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Dillard
authors.forename: Amy R
authors.initials: AR
authors.lastname: Blanchard
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001794:Blood Pressure; D002940:Circadian Rhythm; D045422:Continuous Positive Airway Pressure; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D015431:Weight Loss
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors