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Ambulatory screening for obstructive sleep apnea in patients with resistant arterial hypertension

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
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Abstract

Objective

Obstructive sleep apnea (OSA) is one of the most common causes of secondary arterial hypertension. It is important to rule out OSA as a cause of resistant hypertension. The ApneaLink device is a simple and cost-efficient outpatient examination, but its usefulness in screening OSA in resistant hypertension has not yet been evaluated.

Methods

A total of 69 patients with resistant arterial hypertension were enrolled. Patients underwent a physical examination, including the use of ApneaLink, followed by respiratory polygraphy. The presence of OSA was assessed by the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean nocturnal desaturation (SpO2), and percentage of sleep time with SpO2 less than 90%.

Results

There was no significant difference between the values of AHI found during the use of ApneaLink and respiratory polygraphy (mean 30.4 ± 21.7 vs. 37.2 ± 20.9, P = 0.07). ApneaLink had 77.3% sensitivity and 100% specificity to diagnose OSA with the area under the ROC curve 0.866 (P < 0.001). We also found no significant difference in mean SpO2 (91.3 ± 2.5 vs. 90.9 ± 3.3%, P = 0.22). The ODI evaluated via ApneaLink was significantly lower than by the polygraphy (31.1 ± 18.3 vs. 43.9 ± 24.8, P < 0.001), while the measured percentage of sleep time with SpO2 less than 90% was higher (31.8 ± 23.7 vs. 23.3 ± 24.4, P = 0.001). The severity of OSA was correctly determined by ApneaLink in 50.7% of patients, underestimated in 23.2% and overestimated in 26.1%.

Conclusions

The use of ApneaLink is a suitable method for screening the presence of OSA in patients with resistant hypertension, but to accurately assess the severity of OSA, respiratory polygraphy or polysomnography is required.

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Funding

RVO: 61989592, MH CZ—DRO: 00098892 and ČARO (Czech Alliance against Chronic Respiratory Diseases) provided financial support in the form of financial funding. The sponsor had no role in the design or conduct of this research.

University Hospital Olomouc and Palacky University Faculty of Medicine and Dentistry provided financial support in the form of grant funding UP IGA_LF_2016_037. The sponsor had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Internal Medicine I- Cardiology, University Hospital Olomouc and Palacky University Faculty of Medicine and Dentistry, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic

    Monika Kamasová, Jan Václavík, Eva Kociánová & Miloš Táborský

  2. Statistics and Probability Department, Faculty of Informatics and Statistics, University of Economics in Prague, W. Churchill’s 1938/4, 130 67, Prague, Czech Republic

    Tomáš Václavík

  3. Department of Pulmonary Diseases and Tuberculosis, University Hospital Olomouc and Palacky University Faculty of Medicine and Dentistry, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic

    Milada Hobzová

Authors
  1. Monika Kamasová
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  2. Jan Václavík
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Correspondence to Monika Kamasová.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kamasová, M., Václavík, J., Václavík, T. et al. Ambulatory screening for obstructive sleep apnea in patients with resistant arterial hypertension. Sleep Breath 22, 361–367 (2018). https://doi.org/10.1007/s11325-017-1583-5

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  • DOI: https://doi.org/10.1007/s11325-017-1583-5

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