Our son, who recently underwent quadruple heart bypass surgery, is having very bothersome trouble with elevated blood pressure during the night. His BP is fine when he goes to bed, but during the night he wakes up frequently to find his BP elevated to the point of being of concern. It is an established medical finding that increased BP or hypertension, is a comorbidity with cardiovascular and renal diseases and is thus of interest to readers of this blog.
I turned to the Doctor Sage bot in Poe with the following Prompt and results:
Prompt: What is the association, if any between sleep apnea and hypertension especially at night during sleep?
DoctorSage Poe:
Sleep apnea and hypertension are closely associated with each other, especially during sleep. Here are the key points to consider:
Sleep apnea is a sleep disorder characterized by repeated pauses in breathing or shallow breaths during sleep. These pauses, called apneas, can last for a few seconds to a few minutes and occur multiple times throughout the night.
Hypertension, or high blood pressure, refers to the sustained elevation of blood pressure above normal levels. It is a known risk factor for various cardiovascular diseases.
There is a bidirectional relationship between sleep apnea and hypertension. This means that sleep apnea can contribute to the development and worsening of hypertension, while hypertension can also worsen sleep apnea.
Sleep apnea leads to intermittent hypoxia (low oxygen levels) and increased carbon dioxide levels in the blood, which can activate the sympathetic nervous system and increase blood pressure. The repeated episodes of apnea followed by sudden awakening cause surges in blood pressure during the night, leading to nocturnal hypertension.
Nocturnal hypertension refers to elevated blood pressure levels during sleep. It is particularly significant because it is an independent risk factor for cardiovascular events, such as stroke and heart attack, in patients with sleep apnea.
The increased sympathetic activity and elevated blood pressure during sleep can persist throughout the day, contributing to sustained hypertension even during wakefulness.
Additionally, sleep fragmentation caused by frequent awakenings during sleep apnea can result in poor sleep quality and daytime sleepiness, which can further contribute to the development and worsening of hypertension.
In summary, sleep apnea and hypertension are closely linked, with sleep apnea contributing to the development and worsening of hypertension, and hypertension exacerbating sleep apnea. The surges in blood pressure during sleep and the resultant nocturnal hypertension are particularly important in understanding this association. Early recognition and treatment of sleep apnea are crucial to managing hypertension and reducing the risk of cardiovascular complications.
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