The association between sleep apnea and young adults with hypertension

Asha'ari, Zamzil Amin; Hasmoni, Mohamed Hadzri; Rahman, Jamalludin Ab; Yusof, Rosnida Azura; Ahmad, Raja Ahmad Al'konee Raja Lope

doi:10.1002/lary.23379

Cited by 23 publications

(16 citation statements)

References 32 publications

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“…Third, due to the limited age distribution in the present study, ranging between 40 and 69 years at baseline, the potential impact of snoring on hypertension in adults younger than 40 years old could not be assessed. To date, only a few studies investigated whether SDB increases risk for hypertension in a young‐adult population, and results are extremely controversial (Asha'ari, Hasmoni, Ab Rahman, Yusof, & Ahmad, ; Pensuksan et al, ). Last, the diagnosis of hypertension was based on BP measurements from a single visit.…”

Section: Discussionmentioning

confidence: 99%

Increased risk for new‐onset hypertension in midlife male snorers: The 14‐year follow‐up study

Lee

Choi

Chang

et al. 2018

Journal of Sleep Research

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While the association between sleep-related breathing disorders such as snoring and hypertension has been well established, it still remains unclear whether the association differs by age and gender. Therefore, in this 14-year follow-up study, we examined the independent association between self-reported snoring and the incidence of hypertension by gender and age groups in a large cohort of Korean adults. A total of 4,954 adults, aged 40-69 years, free of hypertension at baseline were enrolled. Participants were divided into three groups based on a self-reported snoring frequency: never; occasional (snoring <4 nights per week); and habitual snorer (snoring ≥4 nights). At baseline and biennial follow-up visits, blood pressure was measured by trained examiners. Incident hypertension was defined as the first occurrence at any follow-up examination where the participants had blood pressure ≥140/90 mmHg or were being treated with antihypertensive medication. After adjusting for known cardiovascular risk factors, only in men aged ≤45 years was habitual snoring significantly associated with a 1.5 times higher risk for incident hypertension than never snoring. In this age group, habitual snoring was significantly associated with increased risk for the development of hypertension, regardless of the presence of excessive daytime sleepiness. In women, snoring was not significantly associated with hypertension incidence in any age group. The present study suggests that young male snorers may be at high risk for the future development of hypertension, which has important clinical implications for early detection and treatment of snoring to reduce the burden of cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

Increased risk for new‐onset hypertension in midlife male snorers: The 14‐year follow‐up study

Lee

Choi

Chang

et al. 2018

Journal of Sleep Research

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“…For instance, short sleep duration was found to be a risk factor in American population [8], while the significant association was not reported in Chinese population [10]. In terms of sleep apnea, positive association (OR = 1.72, AHI ≥ 30) was found in Malaysian young adults [11], there is, however, no significant results were found in French population [12]. Recent data on the effects of sleep status on hypertension should be explored.…”

Section: Introductionmentioning

confidence: 93%

Sleep and hypertension

Han

Chen

et al. 2019

Sleep Breath

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Purpose Hypertension is a global public issue, and sleep status was regarded as its risk factor; however, the results were inconsistent. This study aims to deeply investigate the correlation between sleep status and hypertension. Methods The electronic databases Cochrane Library, Pubmed, and Embase updated to May 31, 2019, were retrieved. Studies were selected according to the predefined screening criteria, and their qualities were assessed by using quality check scales. Based on Stata 15.1 software, the associations between sleep status and hypertension were analyzed by meta-analyses, using odds ratio and 95% confidence interval as effect indexes. Furthermore, publication bias and small study bias were evaluated using Begg and Egger's test. In addition, sensitivity analysis was conducted through ignoring one study per time and then observing its influences on the pooled results. Results A total of 54 studies (involving 1,074,207 subjects) were eligible for this meta-analysis. Six factors were included in this study. Raised blood pressure was associated with obstructive sleep apnea (OSA), oxygen desaturation index (ODI), short sleep duration, and long sleep duration. The differences in ≤ 5 h, 6 h, ≥ 9 h, and 10 h groups had statistical significances, while there was no significant difference in ≥ 8 h group. Snoring is a risk factor of hypertension (OR = 1.94, 95%CI 1.41-2.67). Subgroup analysis was conducted and results were varied. Conclusions The hypertension risk might be reduced by treated OSA, ODI, and snoring, as well as appropriate sleep duration. More studies with large sample sizes and high qualities should be included to support the findings further.

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“…Both Pan et al [ 18 ], in their study on alcohol consumption, chronic diseases and sleep apnea, and hypertension, and Wang et al [ 20 ], in their study on the prevalence of hypertension and circadian blood pressure variations in Chinese patients, found hypertension to be significantly associated with sleep apnea. Asha'ari et al also identified this significant association in a young (mean age of 27) population [ 21 ]. Sleep apnea has been associated with congestive heart failure [ 7 , 9 , 50 , 51 ] and myocardial infarction [ 7 , 52 ], but as “heart disease” in the SARR data was not defined, it is difficult to discuss this finding.…”

Section: Discussionmentioning

confidence: 91%

“…Hypertension has been identified as a risk factor for sleep apnea in numerous studies [ 16 – 18 , 20 , 21 ]. Luyster et al identified a significantly higher cardiovascular risk (BMI ≥ 30 kg/m 2 , sedentary lifestyle, hypertension, and diabetes) in the group with sleep apnea alone [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Sleep Apnea in the Canadian Population

Spuy

Zhao

Karunanayake

et al. 2018

Canadian Respiratory Journal

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Older age, obesity, hypertension, snoring, and excessive daytime sleepiness have been associated with sleep apnea. The objective of this study was to determine the prevalence (crude and adjusted), as well as the risk factors, of sleep apnea in the adult Canadian population. Data from the 2009 Sleep Apnea Rapid Response (SARR) questionnaire were used to identify the risk factors, and all sleep-related questions in the SARR questionnaire were used. The outcome variable of interest was health professional-diagnosed sleep apnea. Covariates of interest were demographic variables, population characteristics, respiratory and cardiovascular diseases, and enabling resources. The multiple logistic regression model adjusted for the clustering effect was used to analyze the data. Sleep apnea was diagnosed in 858,913 adults (3.4% of the population), and more men (65.4%) than women (34.6%) were diagnosed with sleep apnea. Multivariable logistic regression analysis indicated that age (45 and older), loud snoring, sudden awakening with gasping/choking (rare/sometimes and once or more a week), and nodding off/falling asleep in driving in the past 12 months were significantly associated with diagnosed sleep apnea. Predictive probability demonstrated that in overweight and obese persons, ≥15 minutes of daily exercise significantly decreased the risk of diagnosed sleep apnea. The conclusion of this study is that in the Canadian population, sleep apnea is associated with older age, loud snoring, and sleeping problems. The protective effect of exercise warrants further investigation.

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The association between sleep apnea and young adults with hypertension

Cited by 23 publications

References 32 publications

Increased risk for new‐onset hypertension in midlife male snorers: The 14‐year follow‐up study

Increased risk for new‐onset hypertension in midlife male snorers: The 14‐year follow‐up study

Sleep and hypertension

Predictors of Sleep Apnea in the Canadian Population

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