Greater OSA severity was associated with higher nocturnal SBP and possible autonomic imbalance, suggesting ABPM with OSA screening may help identify high-risk nocturnal blood pressure phenotypes in hypertensive patients.
Body mass index differed significantly across OSA severity categories, with severe OSA patients having the highest BMI.
Nocturnal systolic blood pressure fall showed a decreasing trend with increasing OSA severity.
Each 10-event/hour increase in AHI was independently associated with a statistically significant increase in nocturnal systolic blood pressure after adjustment.
Greater OSA severity was associated with possible autonomic imbalance as assessed by heart rate variability.
The study cohort had incomplete overlap between PSG, ABPM, and HRV data, resulting in different sub-cohort sizes for different analyses.
This research suggests that in patients who already have high blood pressure (hypertension), having more severe obstructive sleep apnea (OSA) — a condition where breathing repeatedly stops during sleep — is linked to worse nighttime blood pressure patterns. Specifically, people with more severe OSA showed less of a natural nighttime dip in blood pressure and had higher overall nighttime systolic (top-number) blood pressure. For every 10 additional breathing interruptions per hour during sleep, nighttime systolic blood pressure was about 3.6 mmHg higher, even after accounting for other factors. The study also found that more severe OSA was associated with signs of autonomic nervous system imbalance — meaning the system that automatically regulates heart rate and blood pressure may not function as well. Higher body weight (BMI) was also significantly associated with more severe OSA. These findings come from an observational study of 86 hypertensive adults in China who underwent sleep studies, with subsets also undergoing 24-hour blood pressure monitoring and heart rhythm recording. This research suggests that routinely screening hypertensive patients for sleep apnea and monitoring their nighttime blood pressure could help identify those at particularly high cardiovascular risk. People whose blood pressure does not drop normally during sleep (so-called 'non-dippers') are known to face greater risks of heart attack and stroke, and OSA may be one underrecognized contributor to this pattern. The findings point toward the potential value of combined sleep and blood pressure monitoring in managing patients with hypertension.
Sun H, Xie l, Gan L, Wang Y. (2026). Association of Obstructive Sleep Apnoea Severity with Nocturnal Blood Pressure and Autonomic Dysfunction in Patients with Hypertension.. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. https://doi.org/10.29271/jcpsp.2026.09.1170