O011 Exploring Nocturnal Blood Pressure Surges Relationships with Brain Health and Cognitive Function.

Abstract

Introduction

Cerebral small vessel disease is a possible mechanism to explain the link between long-term incompletely treated obstructive sleep apnoea (OSA) and dementia. Recent evidence suggests nocturnal blood pressure (BP) surges triggered by OSA-related sympathetic hyperactivity could play a critical role. However, this remains to be determined as they often occur concurrently with desaturation events.

Methods

During an in-lab polysomnography study of 7 controls [AHI≤5] and 20 untreated OSA patients [AHI>5] aged 45-65 years the frequency of blood pressure surges (>10% systolic ↑BP) in the presence or not of desaturation events (↓SpO2>3%) were quantified with a SOMNOtouch™ NIBP device. Cerebral perfusion was assessed with pCASL MRI and brain lesions with anatomical MRI scans. The global deficit score was determined for cognitive function assessment. Inflammation was quantified with blood hs-CRP.

Results

After controlling for age, BMI, gender, blood glucose and cholesterol, higher AHI was associated with more frequent BP surges (r=0.52, P=0.03), BP surges occurring with desaturation events (r=0.87, P<0.001), but not with BP surges without oxygen desaturation (P = 0.11). Concurrent BP surges and oxygen desaturation was associated with increased hs-CRP (r=0.55, P=0.02). Frequency of BP surges was not related to cerebral perfusion, brain lesions or the global deficit score.

Conclusions

Recording nocturnal blood pressure surges during polysomnography may provide insight into the cardiovascular burden associated with OSA. Interestingly, an inflammatory response is associated with BP surges only during desaturations, i.e. during respiratory events. Further work is needed to assess the utility of BP surges in predicting longer-term cognitive deficits.