OBSTRUCTIVE SLEEP APNEA SYNDROME IN HYPERTENSIVE WOMEN

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to respiratory interruptions, intermittent hypoxia, sleep fragmentation, and persistent activation of the sympathetic nervous system. In hypertensive women, this condition is clinically significant due to the association between nocturnal respiratory disturbances, endothelial dysfunction, systemic inflammation, and increased vascular resistance. Manifestations in women often include fatigue, insomnia, morning headaches, mood swings, and daytime sleepiness, though these are not always recognized as signs of apnea. Hormonal changes associated with menopause are also considered factors that increase vulnerability, while the coexistence of obesity and hypertension adds complexity to the cardiovascular profile. Objective: To analyze scientific evidence regarding the relationship between OSAS and arterial hypertension in women, considering pathophysiological mechanisms, clinical manifestations, diagnostic methods, and therapeutic options. Methodology: This systematic review was structured based on the recommendations of the PRISMA checklist. The PubMed, SciELO, and Web of Science databases were searched for scientific articles published within the last ten years. Five descriptors were used: “obstructive sleep apnea,” “arterial hypertension,” “women,” “cardiovascular health,” and “blood pressure.” Original studies and scientific reviews relevant to the topic—available in full text and published in Portuguese, English, or Spanish—were included. Duplicate studies, publications unrelated to the hypertensive female population, and works lacking full text or relevant data were excluded. The number of studies selected and the screening results were contingent upon the documented execution of the search process. Results: Scientific evidence has linked obstructive sleep apnea syndrome (OSAS) to poorer blood pressure control, resistant hypertension, and an increased cardiovascular risk. Intermittent hypoxia and sympathetic overactivity promote elevated blood pressure, while inflammation and oxidative stress contribute to vascular dysfunction. The lower rate of symptom recognition in women has hindered timely diagnosis. Conclusion: OSAS is a clinically relevant condition in hypertensive women, necessitating the investigation of both nocturnal and daytime symptoms, an accurate diagnosis, and integrated follow-up care. Early identification and individualized treatment facilitate cardiovascular management, although the magnitude of therapeutic benefits depends on treatment adherence, the severity of the apnea, and the presence of comorbidities.