J Coll Physicians Surg Pak. 2026 Sep;36(9):1170-1174. doi: 10.29271/jcpsp.2026.09.1170.
ABSTRACT
OBJECTIVE: To determine the association of obstructive sleep apnoea (OSA) severity with nocturnal blood pressure patterns, blood pressure variability (BPV), and heart rate variability (HRV) in patients with hypertension.
STUDY DESIGN: An observational study. Place and Duration of the Study: Cardiac Function Laboratory, Department of Cardiology, Xianning Central Hospital, the First Affiliated Hospital of Hubei University of Science and Technology, Xianming, China, from January 2024 to May 2025.
METHODOLOGY: Adult hypertensive patients who underwent polysomnography (PSG) were analysed. OSA severity was defined by the apnoea-hypopnoea index (AHI). Available ambulatory blood pressure monitoring (ABPM) and Holter data were used to assess nocturnal systolic blood pressure (SBP) fall, non-dipping, BPV, and HRV. Group comparisons were performed using the Kruskal-Wallis test, the chi-square test, or Fisher's exact test, as appropriate. Spearman's correlation and regression analyses were performed where appropriate.
RESULTS: Eighty-six patients comprised the PSG cohort; 44 had ABPM data, and 60 had HRV data. Body mass index differed across OSA severity categories (severe OSA: 30.00 [27.92-33.60] kg/m2; p = 0.001). In the ABPM+PSG sub-cohort, nocturnal SBP fall showed a decreasing trend with increasing OSA severity (severe OSA: 2.43 [-1.89 to 7.68%]; p = 0.105). For every 10 events/hour increase in the AHI, nocturnal SBP increased after adjustment (β = 3.63, 95% CI 0.42-6.83; p = 0.032).
CONCLUSION: Greater OSA severity was associated with higher nocturnal SBP and possible autonomic imbalance. ABPM with OSA screening may help identify high-risk nocturnal blood pressure phenotypes in hypertensive patients.
KEY WORDS: Obstructive sleep apnoea, Hypertension, Ambulatory blood pressure monitoring, Circadian rhythm, Blood pressure variability, Heart rate variability.
PMID:42698248 | DOI:10.29271/jcpsp.2026.09.1170