The influence of hypertension on daytime sleepiness in obstructive sleep apnea

Martynowicz, Helena; Skomro, Robert; Gać, Paweł; Mazur, Grzegorz; Porębska, Irena; Bryłka, Agnieszka; Nowak, Wojciech; Zieliński, Michał; Wojakowska, Anna; Poręba, Rafał

doi:10.1016/j.jash.2017.03.004

Cited by 27 publications

(22 citation statements)

References 40 publications

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“…It was found previously that sleepiness as measured by ESS is increased in SB; however, the association of sleepiness with OSA was not assessed in that study [ 45 ]. Recently, we have shown that hypertension with OSA does not show increased ESS compared to normotensive subjects [ 46 ]; this result agrees with result of this study. It is probable that excessive daytime sleepiness is related not only to the AHI but also to central autonomic interactions affecting baroreflex sensitivity [ 47 , 48 ].…”

Section: Discussionsupporting

confidence: 93%

Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

Martynowicz

Dymczyk

Dominiak

et al. 2018

JCM

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Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic). The recent hypothesis on the etiology of SB supports the role of the central and autonomic nervous systems. Therefore, in this study, we aimed to assess the intensity of SB in patients with arterial hypertension. A total of 70 adults participated in this study: 35 patients with hypertension (study group) and 35 normotensive subjects (control group). Data were recorded using home portable cardiorespiratory polygraphy. The bruxism episode index (BEI) in the study group was found to be significantly higher compared to the control group (3.4 ± 3.25 vs. 2.35 ± 2.29, p = 0.04). Hypertension, higher body mass index (BMI), lower values of mean oxygen saturation (SpO2), and a higher percentage of SpO2 < 90% constituted independent risk factors for increased BEI. These results suggest the need for special oral care in hypertensive patients, patients with higher BMI, lower values of SpO2 and a higher percentage of SpO2 < 90%.

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Section: Discussionsupporting

confidence: 93%

Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

Martynowicz

Dymczyk

Dominiak

et al. 2018

JCM

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“…These same findings confirm the results reached by Martynowicz et al [ 22 ] who had conducted a prospective observational controlled study (HT vs non-HT) in 374 patients receiving nocturnal polysomnography. This work showed that in patients with AHI ≥ 15: the ESS score was significantly higher in normotensive patients compared to hypertensive patients (13.80 ± 6.66 versus 9.84 ± 5.56 p < 0.05).…”

Section: Discussionsupporting

confidence: 91%

Screening obstructive sleep apnea-hypopnea syndrome in hypertensive patients: a comparative study of the efficiency of the Epworth sleepiness scale

et al. 2018

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BackgroundUntreated Obstructive Sleep Apnea Hypnopnea Syndrome (OSAHS) is a known factor contributing to resistant hypertension (HT). Continuous Positive Airways Pressure (CPAP) is effective to decrease blood pressure (BP) in severe OSAHS. In our clinical practice, hypertensive patients seem less symptomatic with regard to severe OSAHS than normotensive patients, leading to a risk of underdiagnosis when OSAHS is screened with Epworth Sleepiness Scale (ESS). We aimed to confirm that severe OSAHS is less symptomatic in HT patients than normotensive patients using ESS.MethodsWe retrospectively compared two age, gender-matched groups - 100 hypertensive patients and 100 normotensive patients - with severe OSAHS defined as an AHI (Apnea Hypopnea Index) ≥30. OSAHS was considered symptomatic when ESS > 10.ResultsThe two groups of patients did not differ significantly with respect to main characteristics including Body Mass Index (BMI), AHI and ODI (Oxygen Desaturation Index). Systolic and Diastolic BP were higher in HT patients (p < 0.01). HT patients were less symptomatic with regard to severe OSAHS with a lower ESS (10.0 vs 11.9, p < 0.01), and a lower number of patients with an ESS > 10 (30% vs 58%, p < 0.01). In multivariable analysis adjusted on age, gender, Obesity, Systolic BP, Diastolic BP, AHI and ADO, normotension was significantly associated with symptomatic OSAHS (OR = 2.83, [1.298–6.192], p < 0.01).ConclusionsIn our study on patients with severe OSAHS, ESS score was lower in hypertensive patients than in normotensive patients. This discrepancy may lead to an underestimation of severe OSAHS in hypertensive patients.

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“…The association with the SAOS was clearly demonstrated; however, in patients with cardiovascular disorders this association proved to be limited. Furthermore, myocardial ischemia or heart failure alone can lead to fatigue and excessive daytime sleepiness, even in the absence of SAOS, and medications for cardiac problems, such as β-blockers, can also lead to excessive daytime sleepiness [29][30][31] . Use of nasoenteric probe in adult emergency service There was a statistically significant association between pulmonary diseases and orotracheal intubation (OTI).…”

Section: Discussionmentioning

confidence: 99%

Profile of patients using nasoenteric probe at the adult emergency service in a public hospital

2018

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Introduction: Part of the prognosis of hospitalized patient depends on nutritional status and the safety and efficacy of the feeding administration route. Therefore, the aim of this study was to identify data on the indication of nasoenteric tube (NET) prescription to analyze the profile of these patients. Methods: A retrospective cross-sectional study was carried out with data collection in medical records of patients over 18 years of age, of both sexes, treated at the Emergency Adult Service (EAS), using NET. Results: there was a predominance of females (51.9%); neurological disease was the most prevalent underlying disease, and 57.8% had more than one diagnosed disease. Malnutrition, bronchopneumonia, and dysphagia were present in 23.6%, 27% and 40% of the cases, respectively. There was a request for speech-language evaluation in only 8.7% of the patients. And 80.7% did not use NET prior to emergency care. Regarding the indications for the use of NET by group of underlying disease, low food intake was the most prevalent clinical reason described in the medical records, followed by dysphagia, with a higher prevalence of patients taking NET for nutritional reasons. There was no justification for prescription in 15.2% of the sample. There was an association between the variables bronchopneumonia and dysphagia (p = 0.01). Conclusion: It was verified that in the studied population there are risk factors for dysphagia. The analysis of the population profile in the present study contributed to increased knowledge and information about this population regarding the criteria for indication of the use of the alternative route.

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The influence of hypertension on daytime sleepiness in obstructive sleep apnea

Cited by 27 publications

References 40 publications

Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

Screening obstructive sleep apnea-hypopnea syndrome in hypertensive patients: a comparative study of the efficiency of the Epworth sleepiness scale

Profile of patients using nasoenteric probe at the adult emergency service in a public hospital

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