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Poor blood pressure control following subarachnoid hemorrhage in patients with sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Rationale

Retrospective studies indicate that obstructive sleep apnea occurs often after aneurysmal subarachnoid hemorrhage. We aim to investigate if obstructive sleep apnea is associated with impaired blood pressure control early after subarachnoid hemorrhage.

Methods

Patients with subarachnoid hemorrhage were recruited and screened for sleep apnea using cardiorespiratory polygraphy within 48 h after intensive care unit admission, and 6 months after hospital discharge at home. Blood pressure was continuously measured using intra-arterial catheter within the first 24 h after admission. Time between hospital admission and first blood pressure below 140 mmHg, and time with elevated blood pressure within the first 24 h after admission were compared between patients with and without obstructive sleep apnea.

Results

Of 60 patients, 55 successfully completed the study. Obstructive sleep apnea (AHI > 5/h) was diagnosed in 32% of men and 24% of women. While the time to reach a blood pressure of 140 mmHg did not differ (60.0 ± 26.2 min vs. 49.7 ± 16.4 min; p = 0.74), obstructive sleep apnea patients spent more time with blood pressure above 140 mmHg (292.0 ± 114.0 vs. 96.9 ± 28.3 min per 24 h; p = 0.025, CI 95 −363.6 to −26.5) within the observational period. Only AHI and diagnosed hypertension were significant predictors for elevated blood pressure (R2 0.42; p = 0.03).

Conclusion

Obstructive sleep apnea is associated in our study with poor blood pressure control early after subarachnoid hemorrhage. These patients may need advanced management for blood pressure including management for OSA following subarachnoid hemorrhage. Screening for sleep apnea in patients with subarachnoid hemorrhage is recommended.

Trial registration

ClincalTrials.gov identifier: NCT02724215, registered on March 31, 2016.

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Authors and Affiliations

  1. Department of Neurology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany

    Sebastian Zaremba, Luca Albus & Thomas Klockgether

  2. Department of Sleep Medicine, Seeklinik Brunnen, Gersaustrasse 8, 6440, Brunnen-Ingenbohl, Switzerland

    Sebastian Zaremba

  3. Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany

    Hartmut Vatter & Erdem Güresir

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  1. Sebastian Zaremba
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  2. Luca Albus
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Correspondence to Sebastian Zaremba.

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Zaremba, S., Albus, L., Vatter, H. et al. Poor blood pressure control following subarachnoid hemorrhage in patients with sleep apnea. Sleep Breath 25, 777–785 (2021). https://doi.org/10.1007/s11325-020-02184-0

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  • DOI: https://doi.org/10.1007/s11325-020-02184-0

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