The correlation between rapid eye movement sleep and nocturnal hypertension in patients with obstructive sleep apnea: A retrospective study

Abstract

Obstructive sleep apnea (OSA) is a respiratory disease closely associated with hypertension and heart disease. This study aimed to evaluate the diagnostic value of rapid eye movement (REM) sleep during nocturnal hypertension in OSA patients. We selected 194 patients who underwent polysomnography (PSG) at the Respiratory and Critical Care Medicine Department of Jiading District Central Hospital in Shanghai between January 2021 and August 2023. All patients were assigned to the hypertension and normal blood pressure groups, and the differences between the 2 groups were compared. This study included 194 patients (137 with nocturnal hypertension and 57 with normal nocturnal blood pressure). The proportion of male sex, body mass index, apnea-hypopnea index (AHI), REM sleep duration, percentage of REM sleep duration to total sleep duration, REM-AHI, nonrapid eye movement-AHI, oxygen desaturation index (ODI), REM-ODI, nonrapid eye movement-ODI, and average nighttime heart rate during sleep were higher in the hypertension group than in the normal blood pressure group, and the lowest oxygen saturation was lower than that in the normal blood pressure group (P < .05). Logistic regression analysis showed that REM-AHI was an independent risk factor for nocturnal hypertension (adjusted odds ratio, 1.048; 95% confidence interval, 1.011-1.086; P = .01). Receiver operating characteristic curve analysis showed that the REM-AHI had an area under the curve of 0.721 (95% confidence interval, 0.641-0.801; P < .001) for diagnosing nocturnal hypertension in patients with OSA, with a maximum Youden index of 0.379. The optimal critical value of the REM-AHI was 23.6 times/h, with a sensitivity of 64.2% and specificity of 73.7%. REM sleep is closely related to nocturnal hypertension, and patients with OSA are more prone to cardiovascular events.