Factors associated with undiagnosed obstructive sleep apnoea in hypertensive primary care patients.
OBJECTIVE
In hypertensive primary care patients below 65 years of age, (i) to describe the occurrence of undiagnosed obstructive sleep apnoea (OSA), and (ii) to identify the determinants of moderate/severe OSA.


METHODS
Cross-sectional.


METHODS
Four primary care health centres in Sweden.


METHODS
411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed and treated hypertension (BP >140/90).


METHODS
Occurrence of OSA as measured by the apnoea hypopnoea index (AHI).


RESULTS
Mild (AHI 5-14.9/h) and moderate/severe (AHI > 15/h) OSA were seen among 29% and 30% of the patients, respectively. Comparing those without OSA with those with mild or moderate/severe OSA, no differences were found in blood pressure, pharmacological treatment (anti-hypertensive, anti-depressive, and hypnotics), sleep, insomnia symptoms, daytime sleepiness, or depressive symptoms. Obesity (BMI > 30 kg/m2) was seen in 30% and 68% of the patients with mild and moderate/severe OSA, respectively. Male gender, BMI > 30 kg/m2, snoring, witnessed apnoeas, and sleep duration >8 hours were determinants of obstructive sleep apnoea.


CONCLUSIONS
Previously undiagnosed OSA is common among patients with hypertension in primary care. Obesity, snoring, witnessed apnoeas, long sleep duration, and male gender were the best predictors of OSA, even in the absence of daytime sleepiness and depressive symptoms.
Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden. anders.brostrom@hhj.hj.se
Anders
A
Broström
Ola
O
Sunnergren
Kristofer
K
Årestedt
Peter
P
Johansson
Martin
M
Ulander
Barbara
B
Riegel
Eva
E
Svanborg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult