Sleep Apnea Sleep Deprivation and Obesity
Hi I'm Ananth Karumanchi, a nephrologist at Beth Israel Deaconess Medical Center and a professor of medicineat Harvard Medical School. I'm Virend Somers a cardiologistand professor of medicine at Mayo in Rochester. Somers, why should the hypertension community care about sleepé So, sleep and blood pressure
are very closely linked. Basically, in a physiologic sense, when people fall asleepthe blood pressure falls. What we know is if yourblood pressure doesn't fall at night when you're sleeping you fall into the nondipper category and that puts you at an increased risk of cardiovascular imports.
We also know that if youhave problems during sleep, if you develop obstructive sleep apnea, it will raise your blood pressure at night and raise your blood pressureeven during the day time. And the third compelling reason to care is that people who are sleep deprived don't get enough sleep at night, whether it's by choice
or whether it's by some external course, these people chronically will tend to have higher blood pressures than those who sleep normally. So, in your opinion, do all patients with hypertension would you recommend them to get a screen for some sort of sleep abnormalities.
No, no I wouldn't becausethe number of people with hypertension is so huge that logistically andeconomically wouldn't be feasible to study all these people. So we need to be veryselective on who we study and some of the points tothink about who we study would be people who have witnesses apneas, meaning the wife or husband says
I see him or her stopbreathing during sleep. That's called a witnessed apnea and a great sign of obstructive apnea. The other is if you hypertensive and you have day time somnolence. If you fall asleep duringthe day time very easily, then you quite likely have sleep apnea. If you have significant obesity,