SLEEP-RELATED BREATHING DISORDERS ARE COMMON CONTRIBUTING FACTORS TO THE PRODUCTION OF ESSENTIAL-HYPERTENSION BUT ARE NEGLECTED, UNDERDIAGNOSED, AND UNDERTREATED

There is now strong evidence from animal studies and, in humans, from epidemiological studies as well as from retrospective and prospective intervention studies, that obstructive sleep apnea (OSA) can cause per sistent hypertension not only during sleep but during waking hours as well. There is also some evidence that habitual snoring alone, even wi thout OSA, can do the same. Many of the hitherto unexplained epidemiol ogical, clinical, biochemical, hematological, and physiological abnorm alities seen in essential hypertension (EH) could be explained by the accompanying sleep related breathing disorders (SRBD). Many cases of r esistant hypertension are probably due to SRBD. Recent studies show th at SRBD are extremely common in EH but that the vast majority of patie nts with these sleep disorders are being missed by physicians who are treating the accompanying hypertension, even when the patients already have blatant symptoms of OSA. Recent investigations have shown that t he probable reason for this underdiagnosis of OSA is lack of physician knowledge about the condition. This lack of knowledge is prevalent no t only among family physicians, but among hypertension specialists and researchers in the field of hypertension as well. OSA is a common, ea sily diagnosed, and eminently treatable condition that is associated n ot only with disturbed sleep, loud snoring and excessive daytime sleep iness (which greatly increases the risk of traffic accidents), but als o with hypertension, especially resistant hypertension, a broad range of cardiovascular problems, decreased sexual functioning, memory defic its, difficulty concentrating, and changes in personality and mood. It deserves much more attention by physicians treating hypertension than it is currently getting. (C) 1997 American Journal of Hypertension, L td.