Author(s)

Santosh Kumar Sinha¹, Anand Kumar², Avinash Jain², Ramesh Thakur¹, Chandra Mohan Varma¹, Vinay Krishna¹, Avdhesh Kumar², Nirlep Gajiwala³, Ashok Thakkar³

¹L.P.S. Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India.
²M.L. Chest Hospital, G.S.V.M. Medical College, Kanpur, India.
³Sahajanand Medical Technologies Pvt. Ltd., Surat, India.

Background: Studies have revealed a strong link between sleep-related breathing disorders and essential hypertension. However, the trends of sleep-disordered breathing in hypertensive patients have not been analyzed frequently. Methods: In this prospective, single-center and observational study, random patients with systemic essential hypertension, who were visiting GSVM Medical College, Kanpur, India between December 2012 and July 2014, were selected. After obtaining informed consent, patients were analyzed for symptoms of sleep-disordered breathing and Epworth Sleepiness Scale. Subsequently, all patients underwent overnight polysomnography to estimate the events of apnea and hypopnea. Observed data were compared between stage I and stage II hypertensive patients. Results: A total of 51 patients (age: 45.7 ± 13.43 years), comprising 36 stage I hypertensives and 15 stage II hypertensives, were enrolled in the study. About 47% of these patients displayed no symptoms of sleep-disordered breathing. Compared to stage I hypertensives, higher percentage of stage II hypertensives reported excessive day time sleepiness. Sleep latency time and sleep architecture were comparable between stage I and stage II hypertensives. Stage II hypertensives displayed shorter total sleep time and higher snore time than stage I hyper-tensives. Apnea Hypopnea Index (AHI) values increased with the severity of hypertension. Nocturnal oxygen desaturation was present in 25.0% and 53.3% of stage I and II hypertensives respectively. Mean lowest oxygen saturation was lower and the mean C-reactive protein levels were higher in stage II hypertensives as compared to stage I hypertensives. The mean C-reactive protein levels increased with increasing AHI scores, while the mean lowest oxygen saturation decreased with increasing AHI scores. Conclusion: Almost half of the hypertensives patients reported no symptoms of sleep-disordered breathing. Sleep-disordered breathing was more common and was more severe in majority of patients with stage II hypertension as compared to that in patients with stage I hypertension.

Apnea, Hypertension, Polysomnography, Sleep Disorders

Sinha, S. , Kumar, A. , Jain, A. , Thakur, R. , Varma, C. , Krishna, V. , Kumar, A. , Gajiwala, N. and Thakkar, A. (2015) Analysis of Trends of Sleep-Related Breathing Disorders in Patients with Systemic Essential Hypertension. International Journal of Clinical Medicine, 6, 561-569. doi: 10.4236/ijcm.2015.68075.