Dados do Trabalho

Título

Impact of co-morbid insomnia and sleep apnea (COMISA) in Patients with Hypertension: Preliminary data

Introdução

Hypertension (HTN) is a chronic and prevalent condition, highly associated with sleep disorders such as obstructive sleep apnea (OSA) and insomnia. The potential impact of each of these disorders individually and its combination (known as COMISA) in patients with HTN is not well understood.

Objetivo

To evaluate whether patients with COMISA are independently associated with higher blood pressure (BP) levels. As secondary objectives, we aimed to determine if COMISA contributes to poorer BP control compared to patients with either insomnia or OSA alone, or no OSA/insomnia (control group).

Métodos

We recruited consecutive patients from the HTN outpatient Clinic of the Heart Institute (InCor) of the University of São Paulo, who underwent type IV polysomnography using the Biologix device. Additionally, a clinical evaluation was performed, including clinical history data such as the number of antihypertensive medications in use, comorbidities, collection of anthropometric data, and standardized BP measurement (obtained by averaging three measurements using a validated digital device), as well as the evaluation of insomnia according to DSM V criteria. The statistical analysis of the collected data was conducted using the SPSS statistical program.

Resultados

A total of 150 consecutive patients (66.7% women, mean age 65 years) were evaluated. The mean systolic BP (SBP) was 145±24 mmHg, while the mean diastolic BP (DBP) was 88±15 mmHg. The frequency of OSA, insomnia and COMISA were 12%, 36% and 24.7%, respectively. Compared to the control group (without either condition), those with OSA had a similar rate of uncontrolled office BP (55.5% vs. 73.17%, p=0.182). Similarly, those with insomnia (57.4% vs. 73.17%, p=0.132) and those with COMISA (59.45% vs. 73.17%, p=0.2) also showed similar rates of uncontrolled office BP.

Conclusões

OSA, insomnia and COMISA are highly prevalent among patients with HTN treated in a specialized center. However, these preliminary data showed no significant differences in the office BP control as compared to patients without these sleep disorders.

Palavras -chave

Hypertension; Insomnia; Obstructive Sleep Apnea