SLEEP DISORDERS AND DIURNAL BLOOD PRESSURE RHYTHM IN NEVER TREATED HYPERTENSIVE PATIENTS: PP.32.289

Objective: To establish the relationship between two most frequent sleep disorders - insomnia and obstructive sleep apnea (OSA) and diurnal blood pressure rhythm in patients with never treated hypertension. Methods: We investigated 121 consecutive patients with never treated hypertension, in 117 patients data concerning both insomnia and OSA were collected (92 M,25F; mean age 36,1+/−10,1 yrs). Based on proportional change from awake to asleep systolic BP subjects were classified as dippers >=10% and non-dippers 0–10%. Insomnia was screened by Athens Insomnia Scale (AIS) and defined as the AIS score of >=16. All patients underwent polysomnography - apnea/hypopnea index (AHI) was calculated - mild (AHI 5–15) or moderate-severe (AHI > 15) OSA was diagnosed. We divided patients into 4 groups: without OSA and insomnia (OSA-I-), without OSA but with insomnia (OSA-I+), without insomnia but with OSA (OSA+I-) and with both OSA and insomnia (OSA+I+). Results: Insomnia was diagnosed in 22,2% of patients (median AIS score 9), occurring nonsignificantly more frequently in women than men (p = 0,062). Mild and moderate-severe OSA was diagnosed respectively in 29,9% and 19,7% patients (mean AHI 9,7+/−3,0 and 28,4+/−14,5 respectively), occurring more frequently in men than women (p < 0,001). Both insomnia and OSA occurred in 12 patients (10,3%). Patients in the group OSA-I+ were older. Patients in the OSA+I- and OSA+I+ groups were characterized by higher BMI. There was no difference in non-dipping pattern between the groups (occurring in 46,7%, 46,2%, 43,5% and 18,2% patients in the groups OSA-I-, OSA-I+, OSA+I- and OSA+I+ respectively). There were no differences in BP values as well as BP decline at night and in total sleep time, REM and slow wave sleep time as well as arousal number between the groups. Conclusions: In our studied group of never treaded hypertensive patients there were no differences in BP profile between patients without and with sleep disorders. It should be noted that both insomnia and OSA were mild and did not led to pronounced sleep structure changes.