Differentiation of the Non-dipping Blood Pressure Phenotype in Obstructive Sleep Apnea: An Observational Study

Matilde Valencia-Flores; Victoria Santiago-Ayala; Margarita Fernández López; Jorge Oseguera Moguel; Gerardo Payró Ramirez; Montserrat Reséndiz-Garcia; Montserrat Memetla-Argumedo; Gabriela Gaytán-Cervantes; Ramón Morales-Navarro; Carlos A. Aguilar-Salinas; Donald L. Bliwise

Abstract

Observational Study

Differentiation of the Non-dipping Blood Pressure Phenotype in Obstructive Sleep Apnea: An Observational Study

Matilde Valencia-Flores*, Victoria Santiago-Ayala, Margarita Fernández López, Jorge Oseguera Moguel, Gerardo Payró Ramirez, Montserrat Reséndiz-Garcia, Montserrat Memetla-Argumedo, Gabriela Gaytán-Cervantes, Ramón Morales-Navarro, Carlos A. Aguilar-Salinas and Donald L. Bliwise

Published: 15 May, 2025 | Volume 9 - Issue 1 | Pages: 001-008

Background: Absence of nocturnal decrease in Blood Pressure (BP) (“non-dipping”) has been shown to be a strong and independent predictor of cardiovascular events, target organ damage, cardiovascular sequela and cardiovascular mortality. Obstructive Sleep Apnea (OSA) has been associated with non-dipping with an estimated prevalence of approximately 50%, but factors associated with non-dipping in OSA patients remain poorly understood. In this study, we examined clinically relevant variables associated with non-dipping in OSA.
Methods: Patients (n = 35) undergoing overnight valuation for OSA, laboratory-based polysomnography, structured clinical interviews, and comprehensive metabolic and anthropometric evaluations, and ambulatory BP monitoring for 24 hours. Patients were classified into a) dipping BP group or b) non-dipping BP group, based on (a) a nocturnal systolic BP decrease of 10% - 20% or (b) a systolic BP decrease of < 10%.
Results: Patients had moderate and severe OSA (AHI = 34.8 ± 29.1), and 42.9% demonstrated a non-dipping BP pattern. The severity of OSA measures did not differ between dipping group and non-dipping group. However, Wake after Sleep Onset (WASO) and chronicity of insomnia predicts non-dipping BP independent of demographics, sleep stages, anthropometrics, metabolic measures, or arterial stiffness.
Conclusion: These findings contribute to a better understanding of the cardiovascular impacts of OSA and indicate that sleep quality should be incorporated into clinical assessments and management of OSA patients.

Read Full Article HTML DOI: 10.29328/journal.ach.1001037 Cite this Article Read Full Article PDF

Keywords:
Obstructive sleep apnea; Insomnia; Non-dipping blood pressure; Sleep quality; Running head; Non-dipping BP in OSA patients with poor sleep quality

References

Hermida RC, Ayala DE, Mojon A, Fernández JR. Influence of circadian time of hypertension treatment on cardiovascular risk: results of the MAPEC study. Chronobiol Int. 2010;27:1629–1651. Available from: https://doi.org/10.3109/07420528.2010.510230
Hermida RC, Ayala DE, Mojon A, Fernández JR. Blunted sleep time relative blood pressure decline increases cardiovascular risk independent of blood pressure level – the “normotensive nondipper” paradox. Chronobiol Int. 2013;30:87–98. Available from: http://dx.doi.org/10.3109/07420528.2012.701127
O’Brien E, Sheridan J, O’Malley K. Dippers and non-dippers. Lancet. 1988;2:397. Available from: https://doi.org/10.1016/s0140-6736(88)92867-x
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al.; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–1252. Available from: https://doi.org/10.1161/01.hyp.0000107251.49515.c2
Boggia J, Li Y, Thijs L, Hansen TW, Kikuya M, Björklund-Bodegård K, et al. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. Lancet. 2007;370:1219–1229. Available from: https://doi.org/10.1016/s0140-6736(07)61538-4
Hansen TW, Li Y, Boggia J, Thijs L, Richart T, Staessen JA. Predictive role of the nighttime blood pressure. Hypertension. 2011;57:3–10. Available from: https://doi.org/10.1161/hypertensionaha.109.133900
Kario K, Kanegae H, Tomitani N, Okawara Y, Fujiwara T, Yano Y, Hoshide S. Nighttime blood pressure measured by home blood pressure monitoring as an independent predictor of cardiovascular events in general practice. Hypertension. 2019;73:1240–1248. Available from: https://doi.org/10.1161/hypertensionaha.118.12740
de la Sierra A, Redon J, Banegas JR, Segura J, Parati G, Gorostidi M, et al. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension. 2009;53:466–472. Available from: https://doi.org/10.1161/hypertensionaha.108.124008
Eguchi K, Pickering TG, Hoshide S, Ishikawa J, Ishikawa S, Schwartz JE, et al. Ambulatory blood pressure is a better marker than clinic blood pressure in predicting cardiovascular events in patients with/without type 2 diabetes. Am J Hypertens. 2008;21(4):443–450. Available from: https://doi.org/10.1038/ajh.2008.4
Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA. Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens. 2009;23:645–653. Available from: https://doi.org/10.1038/jhh.2009.9
Hermida RC, Ayala DE, Mojón A, Fernández JR. Decreasing sleep-time blood pressure determined by ambulatory monitoring reduces cardiovascular risk. J Am Coll Cardiol. 2011;58(11):1165–1173. Available from: https://doi.org/10.1016/j.jacc.2011.04.043
Dodt C, Breckling U, Derad I, Fehm HL, Born J. Plasma epinephrine and norepinephrine concentrations of healthy humans associated with nighttime sleep and morning arousal. Hypertension. 1997;30(1 Pt 1):71–76. Available from: https://doi.org/10.1161/01.hyp.30.1.71
Vaile JC, Stallard TJ, al-Ani M, Jordan PJ, Townend JN, Littler WA. Sleep and blood pressure: spontaneous baroreflex sensitivity in dippers and non-dippers. J Hypertens. 1996;14:1427–1432. Available from: https://doi.org/10.1097/00004872-199612000-00007
Sachdeva A, Weder AB. Nocturnal sodium excretion, blood pressure dipping, and sodium sensitivity. Hypertension. 2006;48:527–533. Available from: https://doi.org/10.1161/01.hyp.0000240268.37379.7c
Afsar B, Sezer S, Elsurer R, Ozdemir FN. Is HOMA index a predictor of nocturnal non-dipping in hypertensives with newly diagnosed type 2 diabetes mellitus? Blood Press Monit. 2007;12(3):133–139. Available from: https://doi.org/10.1097/mbp.0b013e3280b08379
Aung AT, Chan SP, Kyaing TT, Lee CH. Diabetes mellitus is associated with high sleep-time systolic blood pressure and non-dipping pattern. Postgrad Med. 2020;132(4):346–351. Available from: https://doi.org/10.1080/00325481.2020.1745537
Nikolaidou B, Anyfanti P, Gavriilaki E, Lazaridis A, Triantafyllou A, Zarifis H, et al. Non-dipping pattern in early-stage diabetes: association with glycemic profile and hemodynamic parameters. J Hum Hypertens. 2022;36(9):805–810. Available from: https://doi.org/10.1038/s41371-021-00587-4
Wolf J, Hering D, Narkiewicz K. Non-dipping pattern of hypertension and obstructive sleep apnea syndrome. Hypertens Res. 2010;33(9):867–871. Available from: https://doi.org/10.1038/hr.2010.153
Pio-Abreu A, Moreno H Jr, Drager LF. Obstructive sleep apnea and ambulatory blood pressure monitoring: current evidence and research gaps. J Hum Hypertens. 2021;35(4):315–324. Available from: https://doi.org/10.1038/s41371-020-00470-8
Hla KM, Young T, Finn L, Peppard PE, Szklo-Coxe M, Stubbs M. Longitudinal association of sleep-disordered breathing and non-dipping of nocturnal blood pressure in the Wisconsin Sleep Cohort Study. Sleep. 2008;31(6):795–800. Available from: https://doi.org/10.1093/sleep/31.6.795
Cuspidi C, Tadic M, Sala C, Gherbesi E, Grassi G, Mancia G. Blood pressure non-dipping and obstructive sleep apnea syndrome: a meta-analysis. J Clin Med. 2019;8(9):1367. Available from: https://doi.org/10.3390/jcm8091367
Pinilla L, Benítez ID, Gracia-Lavedan E, Torres G, Minguez O, Aguilà M, et al. Polysomnographic characterization of circadian blood pressure patterns in patients with obstructive sleep apnea. Sleep. 2023;46(4):zsad031. Available from: https://doi.org/10.1093/sleep/zsad031
Valencia-Flores M, Castaño VA, Campos RM, Rosenthal L, Resendiz M, Vergara P, et al. The siesta culture concept is not supported by the sleep habits of urban Mexican students. J Sleep Res. 1998;7(1):21–29. Available from: https://doi.org/10.1046/j.1365-2869.1998.00087.x
Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107(10):1401–1406. Available from: https://doi.org/10.1161/01.CIR.0000056521.67546.AA
Bilo G, Grillo A, Guida V, Parati G. Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects. Integr Blood Press Control. 2018;11:47–56. Available from: https://www.tandfonline.com/doi/full/10.2147/IBPC.S130277
Kikuya M, Staessen JA, Ohkubo T, Thijs L, Metoki H, Asayama K, et al. Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan. Stroke. 2007;38:1161–1166. Available from: https://doi.org/10.1161/01.STR.0000259604.67283.69
Bastos JM, Bertoquini S, Polonia J. Prognostic significance of ambulatory arterial stiffness index in hypertensives followed for 8.2 years: its relation with new events and cardiovascular risk estimation. Rev Port Cardiol. 2010;29:1287–1303. Available from: https://europepmc.org/article/med/21179973
Gijón-Conde T, Gorostidi M, Banegas JR, de la Sierra A, Segura J, Vinyoles E, et al. Documento de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) sobre monitorización ambulatoria de la presión arterial (MAPA) 2019. Hipertens Riesgo Vasc. 2019;36(4):199–212. Spanish. Available from: https://doi.org/10.1016/j.hipert.2019.05.002
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2018;36:2284–2309. [No direct link provided; typically accessible via institutional subscriptions]
Berry RB, Quan SF, Abreu AR; for the American Academy of Sleep Medicine. AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.6. Darien (IL): American Academy of Sleep Medicine; 2020.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes Care. 2019;42(Suppl 1):S13–S28. Available from: https://doi.org/10.2337/dc19-s002
Loredo JS, Ancoli-Israel S, Dimsdale JE. Sleep quality and blood pressure dipping in obstructive sleep apnea. Am J Hypertens. 2001;14(9 Pt 1):887–892. Available from: https://doi.org/10.1016/s0895-7061(01)02143-4
Booth JN, Anstey DE, Bello NA, Jaeger BC, Pugliese DN, Thomas SJ, et al. Race and sex differences in asleep blood pressure: the Coronary Artery Risk Development in Young Adults (CARDIA) study. J Clin Hypertens (Greenwich). 2019;21(2):184–192. Available from: https://doi.org/10.1111/jch.13474
Mokhlesi B, Finn LA, Hagen EW, Young T, Hla KM, Van Cauter E, et al. Obstructive sleep apnea during REM sleep and hypertension: results of the Wisconsin Sleep Cohort. Am J Respir Crit Care Med. 2014;190(10):1158–1167. Available from: https://doi.org/10.1164/rccm.201406-1136OC
Afsar B, Sezer S, Elsurer R, Ozdemir FN. Is the HOMA index a predictor of nocturnal non-dipping in hypertensive patients with newly diagnosed type 2 diabetes mellitus? Blood Press Monit. 2007;12(3):133–139. Available from: https://doi.org/10.1097/MBP.0b013e3280b08379
Loredo JS, Nelesen R, Ancoli-Israel S, Dimsdale JE. Sleep quality and blood pressure dipping in normal adults. Sleep. 2004;27(6):1097–1103. Available from: https://doi.org/10.1093/sleep/27.6.1097
Bloch KE, Buenzli JC, Latshang TD, Ulrich S. Sleep at high altitude: guesses and facts. J Appl Physiol (1985). 2015;119(12):1466–1480. Available from: https://doi.org/10.1152/japplphysiol.00448.2015
Furian M, Bitos K, Hartmann SE, Muralt L, Lichtblau M, Bader PR, et al. Acute high-altitude exposure, acclimatization and re-exposure on nocturnal breathing. Front Physiol. 2022;13:965021. Available from: https://doi.org/10.3389/fphys.2022.965021
Kinsman TA, Townsend NE, Gore CJ, Hahn AG, Clark SA, Aughey RJ, et al. Sleep disturbance at simulated altitude indicated by stratified respiratory disturbance index but not hypoxic ventilatory response. Eur J Appl Physiol. 2005;94:569–575. Available from: https://doi.org/10.1007/s00421-005-1368-6

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Department of Biotechnology, Uttaranchal college of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India

Archna Dhasmana

“Mobile apps and wearable technology are becoming ubiquitous in our environment. Their integration with healthcare delivery is just beginning to take shape. The early results are promising and the possibilities great."

BS, PharmD., MBA, CPHIMS, FHIMSS, Adjunct Professor, Global Healthcare Management, MCPHS University, Chief Strategy Offi cer, MedicaSoft, Senior Advisor, National Health IT (NHIT) Collaborative for Underserved, New York HIMSS, National Liaison, Health 2.0 Boston, Past Chair, Chair Innovation, USA

Helen Figge

Ph.D, Boston University Department of Communication Sciences and Disorders and Knowledge Research Institute, Inc., 2131 Reflection Bay Drive, Arlington, Texas 76013, USA