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. 2020 May 7:2:100013.
doi: 10.1016/j.sleepx.2020.100013. eCollection 2020 Dec.

Periodic breathing is associated with blood pressure above the recommended target in patients with type 2 diabetes

Andreas W Schreib  1 , Michael Arzt  1 , Iris M Heid  2 , Bettina Jung  3 , Carsten A Böger  3 , Stefan Stadler  1 ; DIACORE study group
Affiliations

Periodic breathing is associated with blood pressure above the recommended target in patients with type 2 diabetes

Andreas W Schreib et al. Sleep Med X. .

Abstract

Background: Due to its prognostic importance for patients with type 2 diabetes (DM2), current guidelines recommend a systolic <130 mm Hg and diastolic <80 mm Hg blood pressure target. Periodic breathing, a form of sleep-disordered breathing, acutely causes repetitive hypoxia, sympathetic nervous system activation as well as oscillations of heart rate and blood pressure. However, limited data on the association of periodic breathing and control of blood pressure (BP) in patients with DM2 are available. Thus, the aim of the present study was to assess whether there is an association between periodic breathing and increased BP above the recommended target in DM2.

Methods: Cross-sectional data of 679 patients with DM2 from the DIACORE-SDB sub-study were analysed for association of periodic breathing with BP. Sleep-disordered breathing was assessed with a 2-channel ambulatory monitoring device including validated automatic pattern recognition for periodic breathing. BP values were determined in a standardized manner with three repeated measurements at rest.

Results: Of the 679 analysed individuals (61% male, age 66 ± 9 years, Body Mass Index [BMI] 31.0 ± 5.4 kg/m2), 11% had periodic breathing. Patients with periodic breathing had significantly higher systolic BP values (144 ± 19 mm Hg vs. 137 ± 18 mm Hg, p = 0.003). Multivariable regression analysis revealed that periodic breathing was associated with higher systolic BP (B [95% confidence interval, CI] = 4.4 [0.1; 8.7], p = 0.043) and not meeting the recommended BP target for patients with diabetes (<130/80 mmHg) (odds ratio, OR [95%CI] = 2.1 [1.1; 4.0], p = 0.026) independent of sex, age, high density lipoproteins, renal function, coronary heart disease and antihypertensive treatment.

Conclusion: Periodic breathing is associated with higher systolic BP in patients with DM2.

Keywords: Arterial hypertension; Cheyne-stokes-respiration; Periodic breathing; Sleep-disordered breathing; Systolic blood pressure; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no conflict of interest. The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: https://doi.org/10.1016/j.sleepx.2020.100013.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Study flow chart [17,18]. TRT: total recording time.
Fig. 2
Fig. 2
Bar charts indicating the systolic blood pressure between groups with and without periodic breathing as well as with and without sleep-disordered breathing.
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