Supplemental Digital Content is available in the text. Due to frequent abnormal breathing events and their effects on sleep architecture, patients with obstructive sleep apnea (OSA) exhibit decreased amounts of slow wave sleep (SWS). Reduced SWS has been linked to hypertension in community-based studies. We sought to investigate whether SWS percentage modifies the association between OSA and prevalent hypertension. We studied 7107 patients with OSA and 1118 primary snorers who underwent in-laboratory polysomnography. Patients were classified into quartiles of percent SWS. Hypertension was defined based either on clinic blood pressure measures or on physician diagnosis. Multivariable logistic regression model showed a significant interaction effect of OSA and SWS on prevalent hypertension (P=0.002). Decreased SWS was associated with higher odds for hypertension in OSA but not in primary snoring, with patients with OSA exhibiting <0.1% SWS (OR, 1.44 [95% CI, 1.21–1.70]; P=0.001) and those with 0.1% to 4.8% SWS (OR, 1.20 [95% CI, 1.03–1.40]; P=0.02) being more likely to have hypertension compared with those with >11.1% SWS. In analysis stratified by OSA severity, significant associations between percent SWS and blood pressure emerged only in moderate and severe OSA. Effect modifications by sex (P=0.040) and age (P=0.007) were also only evident in OSA, indicating that decreased SWS was associated with hypertension only in men and in patients <60 years old. Decreased SWS is associated with a dose-dependent increase in odds of prevalent hypertension in patients with OSA. The effects of SWS are likely to be modulated by OSA severity. SWS may be implicated in the heightened risk of cardiovascular diseases exhibited by patients with OSA.

中文翻译：

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慢波睡眠与阻塞性睡眠呼吸暂停在流行性高血压中的相互作用

补充数字内容在文本中可用。由于频繁的异常呼吸事件及其对睡眠结构的影响，阻塞性睡眠呼吸暂停 (OSA) 患者的慢波睡眠 (SWS) 数量减少。在基于社区的研究中，降低的 SWS 与高血压有关。我们试图调查 SWS 百分比是否会改变 OSA 与普遍高血压之间的关联。我们研究了 7107 名 OSA 患者和 1118 名接受实验室内多导睡眠监测的原发性打鼾者。患者被分为 SWS 百分比的四分位数。高血压是根据临床血压测量值或医生诊断来定义的。多变量逻辑回归模型显示 OSA 和 SWS 对流行性高血压有显着的交互作用（P=0.002）。SWS 降低与 OSA 高血压风险相关，但与原发性打鼾无关，OSA 患者 SWS <0.1%（OR，1.44 [95% CI，1.21–1.70]；P=0.001），0.1% 至4.8% SWS (OR, 1.20 [95% CI, 1.03–1.40]; P=0.02) 与 >11.1% SWS 的患者相比，患高血压的可能性更大。在按 OSA 严重程度分层的分析中，SWS 百分比与血压之间的显着关联仅在中度和重度 OSA 中出现。性别 (P=0.040) 和年龄 (P=0.007) 的影响改变也仅在 OSA 中明显，表明 SWS 降低仅与男性和 <60 岁以下患者的高血压相关。降低的 SWS 与 OSA 患者普遍高血压的几率呈剂量依赖性增加相关。SWS 的影响可能受 OSA 严重程度的调节。