Screening of obstructive sleep apnea in patients with hypertension: review of the literature and results of an Italian survey

Obstructive sleep apnea (OSA) is a common disorder in the general population and individuals with hypertension. We reviewed the literature on the prevalence of OSA in hypertension and hypertension subgroups. The current literature shows a high prevalence of OSA in patients with nocturnal and resistant hypertension, up to more than 90% in patients with refractory hypertension. The prevalence of OSA in patients with primary aldosteronism is greater than 45%. We also conducted an Italian national survey to assess the diagnostic approach to OSA in centers associated with European and Italian Societies of Hypertension. The median rate of OSA diagnosis was 10patients/year, with a higher rate in Excellence Centers. The most common criterion for OSA screening was the combination of hypertension, snoring, and daytime somnolence (90%), followed by hypertension and a nondipping profile (55%). Resistant hypertension was considered a criterion by only 23% of the specialists.