SHORT-TERM VARIABILITY OF BLOOD-PRESSURE DURING SLEEP IN SNORERS WITHOR WITHOUT APNEA

Citation
M. Leroy et al., SHORT-TERM VARIABILITY OF BLOOD-PRESSURE DURING SLEEP IN SNORERS WITHOR WITHOUT APNEA, Hypertension, 28(6), 1996, pp. 937-943
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
Journal title
ISSN journal
0194-911X
Volume
28
Issue
6
Year of publication
1996
Pages
937 - 943
Database
ISI
SICI code
0194-911X(1996)28:6<937:SVOBDS>2.0.ZU;2-9
Abstract
In normal subjects, the level and variability of blood pressure decrea se during non-rapid eye movement (non-REM) sleep. In contrast, sleep a pnea is associated with large swings in nocturnal pressure. In this st udy, we evaluated a computer-derived index of all-night blood pressure variability in normotensive snorers with or without sleep apnea. We a lso examined this index in snorers receiving medical treatment for coe xistent ischemic heart disease. Beat-to-beat blood pressure was record ed with a photoplethysmographic device (Finapres) throughout polysomno graphy. Subjects were categorized into four groups: those without card iovascular disease without or with sleep apnea (greater than or equal to 15 apnea plus hypopnea per hour of sleep), and those with ischemic heart disease without or with sleep apnea. A frequency distribution hi stogram of all increases and decreases of blood pressure according to their amplitudes was drawn and the SD of the distribution used as an e stimation of variability. Mean systolic and diastolic pressures during the total sleep time were not different among the four groups. In con trast, the SD of the distribution of systolic and diastolic pres sure variations that were higher in the apneic than in the nonapneic groups (P < .05) correlated with apnea plus hypopnea (P < .0001) and transie nt electroencephalographic arousal number per hour of sleep (P < .0001 ). In both apneic and nonapneic subjects, blood pressure variability a s assessed by SD decreased during stages 3 and 4 of non-REM sleep comp ared with stages 1 and 2 and REM sleep (P < .001). Blood pressure vari ability was similarly increased in apneic subjects with or without isc hemic heart disease. We speculate that in apneic individuals with coex istent ischemic heart disease, pressure variability that is increased despite treatment with P-blockers or calcium antagonists may be a risk factor for acute coronary events.