AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Polysomnography-Derived Obstructive Sleep Apnea Severity, Wake After Sleep Onset, and Blood Pressure in Black and Hispanic Women of Childbearing Age
By Wang Z, Sharma Y, Condon E et al.
Introduction: Obstructive sleep apnea (OSA) is associated with blood pressure (BP) elevations and hypertension. Black and Hispanic women of childbearing age (WOCBA) are at high risk for hypertension throughout their lives, including during pregnancy, and increased prevalence of OSA, yet there has been little research focused on the associations between OSA severity and blood pressure in this population. Research Question: The purpose of this study was to examine the associations of OSA severity and objective sleep architecture with systolic BP, diastolic BP, and mean arterial pressure (MAP) among Black and Hispanic WOCBA. Methods: We used data from an ongoing cross-sectional study of sleep health among Black and Hispanic women aged 18 to 49 years. Participants completed one night of unattended level II home polysomnography (PSG) using the Sleep Profiler PSG2 (Advanced Brain Monitoring, Inc). We quantified OSA severity with the PSG-derived apnea-hypopnea index (AHI) based on the 3% desaturation rule and examined sleep metrics [e.g., duration, latency, wake after sleep onset (WASO)]. Daytime BP was measured at a single visit using an automated BP monitor, with three sequential readings; the average of the readings was used in the analysis. BP was categorized using 2025 AHA/ACC guidelines. We tested bivariate-significant metrics in covariate-adjusted ordinary least squares regression models (OLS). Results: Among 154 participants (M age=28.2, SD=8.7 years), 55.2% identified as Hispanic, 27.9% as non-Hispanic Black, 11.7% as Hispanic Black, and 5.2% as multiracial. The median AHI was 1.37 events/hour (IQR: 0.57-4.01); AHI severity categories were 79.9% AHI <5, 14.9% mild, 3.9% moderate, and 1.3% severe. Mean systolic BP, diastolic BP, and MAP were 113.3±13.0, 76.8±9.6, and 89.0±9.9 mmHg, respectively; BP categories were 61.7% normal, 3.3% elevated, 24.0% stage 1 hypertension, and 11.0% stage 2 hypertension. Participants with AHI ≥5 had a nearly two-fold higher prevalence of BP above the normal range than those with AHI <5 (61.3% vs. 32.5%, p =.003). In age- and BMI- adjusted OLS models, each 1-event/hour higher AHI was associated with 0.47 mmHg higher systolic BP (95% CI: 0.09, 0.85; p =.017). The AHI was not associated with the diastolic BP or MAP. Each 10-minute increase in WASO was associated with 0.52 mmHg higher systolic BP after adjustment for age and BMI (95% CI: 0.02, 1.02; p =.033). Conclusions: Although overall OSA severity was low, approximately one in five Black and Hispanic WOCBA had mild or greater OSA. Greater OSA severity and longer WASO were associated with higher systolic BP. OSA and WASO may be actionable targets for BP risk reduction among Black and Hispanic WOCBA. Larger longitudinal studies incorporating nocturnal or 24-hour ambulatory BP monitoring are needed to determine whether OSA severity and WASO contribute to incident hypertension.