Identifying a Link Between Hypertension and Sleep Apnea
The physician-patient dialogue should include questions about the patient's sleep habits; quality of sleep; snoring (bed partners are the best source of this information); nighttime anxiety attacks; abnormal breathing sounds such as coughing gasping or wheezing; restlessness while trying to sleep; excessive daytime sleepiness; and the effects of sleep conditions on mental status and mood.
The physical exam should not address the patient's weight alone. In fact, although the morbidly obese generally have more severe degrees of sleep-related breathing disorders, many non-obese patients also suffer from the disorder.
Neck girth may be a more sensitive indicator for sleep apnea. Individuals with short, wide necks show an increased incidence of sleep apnea than those with long, thin necks.
A thorough exam of the oral pharynx and mouth may reveal a narrowed airway due to redundant tissue, or reddening of the soft tissue.
Although males with sleep apnea statistically outnumber females, the history and physical should not differ between the sexes.
A complete polysomnogram, or sleep study, is required to definitively diagnose sleep apnea.
Hypertension - such as primary hypertension - is a serious condition and must be treated. It may also be a sign or symptom of another condition, such as obstructive sleep apnea.
Complete and accurate diagnosis of the underlying cause of hypertension and cardiac disease could have a tremendous impact on treatment and restoring a more healthy life.