SLEEP FRAGMENTATION AS A RISK FACTOR FOR HYPERTENSION IN MIDDLE-AGED NONAPNEIC SNORERS

Although a high prevalence of hypertension has been observed in snorer s, whether there is a direct link between hypertension and snoring rem ains controversial, It has recently been demonstrated that an abnormal amount of breathing effort during snoring is responsible for sleep fr agmentation even in the absence of sleep apnea syndrome criteria, We h ypothesized that sleep fragmentation during snoring may be a direct ri sk factor for the development of hypertension. On the basis of polysom nographic data, 105 nonapneic patients between 40 and 65 years of age referred for snoring with social impairment were selected and categori zed as snorers with (n=55) or without sleep fragmentation (n=50) based on whether the arousals index was 10 or greater or less than 10/h of sleep, respectively. Sleep distribution did not differ between the two groups, except for a longer duration of wake after sleep onset (58+/- 43 min vs 42+/-38 min) and a shorter duration of slow-wave sleep in th e group with sleep fragmentation (72+/-34 min vs 97+/-34 min). Althoug h there were no statistically significant differences between the snor ers with and without sleep disruption in terms of age (51.3+/-7.7 vs 4 8.6+/-6.0 years), body mass index (26.9+/-4.0 vs 27.2+/-5.5 kg/m(2)), sex ratio, respiratory indexes during sleep, daytime sleepiness, and d aytime tiredness, prevalence of systemic hypertension was significantl y higher in the sleep-fragmented group (20/55 vs 7/50). This significa nt difference persisted (16/51 vs 6/49) when patients using antihypert ensive drugs with possible effects on the CNS were excluded. Our data suggest that sleep fragmentation is common in patients who seek medica l help for snoring with social impairment and may play a role in the d evelopment of hypertension.