title: Cumulative association of obstructive sleep apnea severity and short sleep duration with the risk for hypertension.
abstract: Obstructive sleep apnea (OSA) and short sleep duration are individually associated with an increased risk for hypertension (HTN). The aim of this multicenter cross-sectional study was to test the hypothesis of a cumulative association of OSA severity and short sleep duration with the risk for prevalent HTN. Among 1,499 patients undergoing polysomnography for suspected OSA, 410 (27.3%) previously diagnosed as hypertensive and taking antihypertensive medication were considered as having HTN. Patients with total sleep time (TST) <6 h were considered to be short sleepers. Logistic regression procedures were performed to determine the independent association of HTN with OSA and sleep duration. Considering normal sleepers (TST ≥6 h) without OSA as the reference group, the odds ratio (OR) (95% confidence intervals) for having HTN was 2.51 (1.35-4.68) in normal sleepers with OSA and 4.37 (2.18-8.78) in short sleepers with OSA after adjustment for age, gender, obesity, diabetes, depression, current smoking, use of thyroid hormones, daytime sleepiness, poor sleep complaint, time in bed, sleep architecture and fragmentation, and study site. The risk for HTN appeared to present a cumulative association with OSA severity and short sleep duration (p<0.0001 for linear trend). The higher risk for HTN was observed in short sleepers with severe OSA (AHI ≥30) (OR, 4.29 [2.03-9.07]). In patients investigated for suspected OSA, sleep-disordered breathing severity and short sleep duration have a cumulative association with the risk for prevalent HTN. Further studies are required to determine whether interventions to optimize sleep may contribute to lower BP in patients with OSA.
authors.affiliation: Université d'Angers, Département de Pneumologie, CHU, Angers, France; INSERM 1063, Angers, France.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Priou
authors.affiliation: CERMES, CNRS UMR8211 - Inserm U988 - EHESS, Villejuif, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Le Vaillant
authors.affiliation: Université d'Angers, Département de Pneumologie, CHU, Angers, France; INSERM 1063, Angers, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meslier
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Le Mans, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Paris
authors.affiliation: Unité de Pneumologie, Pôle santé des Olonnes, Olonne sur Mer, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pigeanne
authors.affiliation: Centre d'Etude et de Traitement des Troubles du Sommeil de Saint-Antoine (CETTSA), Hôpital Saint-Antoine, Groupe Hospitalier de l'Est Parisien, Paris, France.
authors.forename: Xuan-Lan
authors.initials: XL
authors.lastname: Nguyen
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Cholet, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Alizon
authors.affiliation: Service de Pneumologie, Centre Hospitalier, La Roche sur Yon, France.
authors.forename: Acya
authors.initials: A
authors.lastname: Bizieux-Thaminy
authors.affiliation: Service d'Explorations Fonctionnelles, Hôpital Laennec, Nantes, France.
authors.forename: Laurene
authors.initials: L
authors.lastname: Leclair-Visonneau
authors.affiliation: Pneumologie, Nouvelles Cliniques Nantaises, Nantes, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Humeau
authors.affiliation: Université d'Angers, Département de Pneumologie, CHU, Angers, France; INSERM 1063, Angers, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gagnadoux
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011379:Prognosis; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D012892:Sleep Deprivation / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors