• Sleep apnea;
  • hypertension;
  • young adult;
  • airway;
  • Levels of Evidence: 3b



To study the association between sleep apnea and hypertension in a younger age group than previously studied, adding upper airway sizes at endoscopy as important compounding variables not often included in the past.

Study Design:

Case control.


We analyzed data on sleep-disordered breathing (based on polysomnography tests), body mass index (BMI), neck circumference, upper airway endoscopy sizes, and habitus and health history in 120 hypertensive and 120 nonhypertensive participants in a clinic-based setting. Independent t test, χ2, multivariate analysis, and binary logistic regression models were used for case-control comparison.


The mean age of the participants was 27 years; 67.5% were male. The incidence and severity of sleep apnea were significantly higher in the hypertensive than the control subjects. Persons with hypertension had an OR of 2.7 times of having comorbid sleep apnea than patients without hypertension (95% confidence interval [CI] 1.2-6.1). Persons with sleep apnea (AHI [apnea-hypopnea index] ≥5) had an OR of 2.76 (95% CI 1.57-4.86), and persons with severe sleep apnea (AHI ≥30) had an OR 7.94 (95% CI 4.21-15.33) for having hypertension than did persons without sleep apnea. Although adjustments for the compounding factors, particularly BMI, decreased the OR to a large degree, subjects with severe sleep apnea were still 72% more likely to have hypertension than subjects without sleep apnea.


Sleep apnea is related to hypertension in young adults aged 18 to 40 years. The association was more pronounced with the increasing severity of sleep apnea. Screening for sleep apnea should be considered in young adults with hypertension.