Obstructive sleep apnea and hypertension: The state of the problem from the eyes of a somnologist. Case report

Obstructive sleep apnea (OSA) is one of the most common conditions directly related to sleep and is associated with many cardiovascular complications. The prevalence of hypertension among patients with OSA significantly exceeds that in the general population. OSA can both lead to the occurrence of hypertension, complicate its course, and cause resistance to drug therapy. Also, OSA often leads to a change in the daily blood pressure (BP) profile with no physiological decrease or increase during sleep. Physicians should be alert to patients who are snoring and experiencing daytime sleepiness, especially if they are middle-aged, overweight men. An abnormal diurnal profile of BP and/or hypertension resistant to multicomponent antihypertensive therapy also indicates probable OSA in such patients. The diagnosis of OSA should always be confirmed using special instrumental examination methods. The most effective and safe treatment method for clinically significant OSA is non-invasive ventilation with constant positive airway pressure (CPAP therapy). Proper treatment of OSA often leads to normalizing the diurnal blood pressure profile, decreasing BP both during sleep and wakefulness, and restoring sensitivity to antihypertensive drug therapy.