TITLE:
Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health
AUTHORS:
Anders Broström, Ola Sunnergren, Kristofer Årestedt, Peter Johansson, Per Nilsen, Bengt Fridlund, Eva Svanborg
KEYWORDS:
Depression; Global Perceived Health; Hypertension; Nursing Care; Obstructive Sleep Apnea; Sleep Disordered Breathing; Sleep
JOURNAL NAME:
Open Journal of Nursing,
Vol.3 No.6,
October
24,
2013
ABSTRACT: Objective: 1)
To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive
symptoms in hypertensive men and women below 65 years of age, and 2) to
describe the association of OSA to subjective sleep complaints, depressive
symptoms and global perceived health. Design: Cross-sectional design focusing
on nursing care outcomes of obstructive sleep apnea. Setting: Four primary
care health centres in Sweden.
PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9
years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures:
Prevalence of OSA and depressive symptoms, and association of OSA to sleep
complaints, depressive symptoms and global perceived health. RESULTS: Mild,
moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively.
Depressive symptoms were seen in 16% of the total group, with a higher prevalence
among men, compared to women, 21% vs. 12%. No differences were found
regarding blood pressure, estimated sleep need, sleep sufficiency index,
insomnia symptoms,
daytime sleepiness or depressive symptoms with respect to different degrees of
OSA. Apnea-hypopnea index was significantly associated to perceived health
after adjustment for gender and comorbidities, but when depressive symptoms and
non-restorative sleep were added to the model, 33% of the variance in global
perceived health was explained. Conclusion: OSA is highly prevalent among
patients with hypertension in primary care and does together with sleep complaints
and depressive symptoms have a negative impact on global perceived health.
Hypertensive patients without subjective sleep complaints or depressive symptoms
may still have OSA.