Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study

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Abstract
Sleep-disordered breathing (SDB) and the related clinical syndrome, sleep apnea, have been associated with hypertension in clinical reports since the early 1980s.1-4 Earlier studies of this association used self-reported history of "snoring" as a surrogate for the presence of sleep apnea. Although some of these studies showed an independent association between snoring and hypertension,5-7 others found that this relationship may be explained by confounding effects of age, sex, or obesity.8-11 Two recent studies have demonstrated that self-reported history of snoring is associated with increased incidence of self-reported hypertension in middle-aged men12 and women.13 Other studies have used polysomnography (PSG), a more objective measure of SDB. Most of these studies,14-19 but not all,20,21 found an association between sleep apnea and hypertension, independent of age, sex, body weight, and other potential confounders. With the exception of the reports from the Wisconsin Sleep Cohort Study of middle-aged employed persons,15,18 most previous studies were based on a small number of patients in clinical settings.22