Screening method for severe sleep-disordered breathing in hypertensive patients without daytime sleepiness

J Cardiol. 2009 Feb;53(1):79-85. doi: 10.1016/j.jjcc.2008.09.002. Epub 2008 Oct 31.


The high prevalence of sleep-disordered breathing (SDB) in hypertensive patients has been well studied. However, regular screening of SDB in these patients is not performed routinely as the diagnostic procedures are both time-consuming and labour-intensive. Overnight portable device screening is useful, but is sometimes not acceptable for asymptomatic SDB patients. We evaluated the usefulness of daytime 30-min recording with a portable recording device during pulse wave velocity (PWV) measurement sessions as a screening method for detection of asymptomatic SDB in hypertensive patients. Eighty-one hypertensive patients underwent 30-min daytime screening session using a Type III portable recording device during PWV measurement. Each screening session was followed by full overnight Level I polysomnography (PSG). The screening session included recordings of airflow (mouth-nose), chest movement, oximetry, and electrocardiography. The correlation coefficient between respiratory disturbance index (RDI) by screening session and apnea-hypopnea index (AHI) by PSG was 0.64. Using AHI ≥ 30 as diagnostic of severe SDB, 47 of 80 patients had the disorder based on PSG results. Using an RDI cut-off value of 22, the sensitivity and specificity for detection of severe SDB were 86.1% and 64.5%, respectively. Daytime 30-min recording with a portable device for apnea detection during PWV recording is useful for screening of asymptomatic severe SDB in hypertensive patients.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Electrocardiography
  • Female
  • Humans
  • Hypertension / complications*
  • Male
  • Oximetry
  • Polysomnography
  • Pulmonary Ventilation
  • Pulse
  • Sensitivity and Specificity
  • Sleep Apnea Syndromes / diagnosis*
  • Thoracic Wall / physiology