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Sleep and Breathing

, Volume 22, Issue 2, pp 337–343 | Cite as

Nocturnal blood pressure fluctuations measured by using pulse transit time in patients with severe obstructive sleep apnea syndrome

  • Jennifer Gehring
  • Heiko Gesche
  • Gesine Drewniok
  • Gert Küchler
  • Andreas Patzak
Sleep Breathing Physiology and Disorders • Original Article

Abstract

Background

Obstructive sleep apnea syndrome (OSAS) is related to arterial hypertension. In the present study, we test the hypothesis that patients with severe OSAS have excessive apnea induced blood pressure (BP).

Methods

We investigated 97 patients with an apnea/hypopnea index (AHI) greater than 30. Systolic BP (SBP) was continuously determined by using the pulse transit time (PTT). Apnea/hypopnea induced nocturnal BP fluctuations (NBPFs) were detected and showed phenomena of continuous increases of the SBP baseline. Such periods of SBP baseline elevations ≥ 10 mmHg were called superposition. Respiratory and cardiac parameters were obtained from the polysomnographic investigation.

Results

Eighty-four periods of superposition were detected in 48 patients. They occurred mainly during REM sleep (76%). Apnea duration was increased and the time in respiration was reduced in periods of superposition compared to non-superposition periods. In superposition periods mean oxygen saturation (SpO2) and the minimal SpO2 were lower, desaturations were more pronounced, and the mean heart rate (HR) was increased. The maximum SBP during superposition was significantly increased (204 ± 32 vs.171 ± 28 mmHg). The clinic BP was higher in patients with superposition (SBP 149.2 ± 17.5 vs. 140 ± 19.1, DBP 91.5 ± 11.5 vs. 86.3 ± 11.8).

Conclusions

The study reveals that patients with severe OSAS can have periods of BP superposition during night with extremely high SBP and very low oxygen saturation, which may add to a high risk for cardiovascular events during the night.

Keywords

Obstructive sleep apnea Blood pressure Nocturnal blood pressure fluctuations Pulse transit time Hypertension 

Notes

Acknowledgements

The authors thank Dr. A. Göhler and Mrs. Rebecca Müller for their help in preparing the manuscript.

Funding

No funding was received for this research.

Compliance with ethical standards

Conflict of interest

J.G. is an employee and G.K. is the CEO of SOMNOmedics GmbH. A.P. advices SOMNOmedics in methods of BP measurement and received travel support. The authors certify that they have no other affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, nor other equity interest; and expert testimony or patent-licensing arrangements) or no non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Supplementary material

11325_2017_1555_MOESM1_ESM.docx (32 kb)
Table S1 (DOCX 31 kb)
11325_2017_1555_MOESM2_ESM.docx (30 kb)
Table S2 (DOCX 30 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.SOMNOmedics GmbHRandersackerGermany
  2. 2.Institute of Vegetative PhysiologyCharité-Universitätsmedizin BerlinBerlinGermany
  3. 3.Klinik AmseeSchlaflaborWarenGermany

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