TY - JOUR
T1 - Impact of Sleep-disordered Breathing Management in Primary Care on Systemic Hypertension Control
T2 - Protocol for the METASLEEP Implementation Trial
AU - Pinilla, Lucía
AU - Benítez, Ivan D.
AU - Moncusí-Moix, Anna
AU - Torres, Gerard
AU - Casanovas-Salvatella, Olga
AU - Juez-Garcia, Ivan
AU - Gracia-Lavedan, Esther
AU - Alonso-Fernández, Alberto
AU - Caballero-Eraso, Candela
AU - Cano-Pumarega, Irene
AU - Boira, Ignacio
AU - Egea, Carlos
AU - González, Mónica
AU - Mediano, Olga
AU - Roncero, Alejandra
AU - Roche-Campo, Ferran
AU - Sánchez-Quiroga, Maria Ángeles
AU - Chai-Coetzer, Ching Li
AU - Sánchez-de-la-Torre, Manuel
AU - Barbé, Ferran
AU - de Batlle, Jordi
AU - on behalf of the Spanish Sleep Network
PY - 2026/1/1
Y1 - 2026/1/1
N2 - Introduction: Hypertension is the leading cause of cardiovascular disease, with nocturnal blood pressure (BP) abnormalities (nocturnal hypertension and non-dipping BP) linked to heightened risk. Obstructive sleep apnea (OSA), a modifiable contributor to impaired nighttime BP regulation, commonly co-occurs with hypertension. Primary care (PC) represents a strategic setting for their integrated management. The METASLEEP study aims to develop, implement, and evaluate a novel PC-based hypertension care model incorporating OSA diagnosis, treatment, and home monitoring to improve BP control.Objectives: To describe the rationale, design, methodology, and baseline participant characteristics of the 2024 initiation phase of the METASLEEP trial.Material and methods: Prospective, longitudinal, real-world implementation study conducted across 10 Spanish regions (ClinicalTrials.gov NCT05986487). Adults with hypertension and no prior OSA diagnosis undergo 24-h ambulatory BP monitoring (ABPM) in PC (target n = 1523). Participants with nocturnal hypertension and/or non-dippers receive PC-led OSA diagnostic testing, treatment, and home monitoring via an under-mattress sensor. Follow-ups at 6 and 12 months evaluate changes in nighttime BP (primary) and other clinical outcomes. Results: By end of 2024, 553 patients completed baseline ABPM. Of these, 288 (52.1%) showed nocturnal BP abnormalities: 248 (44.8%) had nocturnal hypertension and 211(38.4%) were non-dippers. Participants were middle-aged, overweight, and frequently had comorbid dyslipidemia, obesity, and diabetes. OSA prevalence was 22.6% mild, 34.1% moderate, and 35.3% severe. CPAP treatment was initiated in 79.4% of moderate-to-severe cases.Conclusions: METASLEEP introduces a novel PC-based model integrating OSA diagnosis and management within hypertension care. Early data reveal notably high prevalence of undiagnosed OSA in hypertensive patients.
AB - Introduction: Hypertension is the leading cause of cardiovascular disease, with nocturnal blood pressure (BP) abnormalities (nocturnal hypertension and non-dipping BP) linked to heightened risk. Obstructive sleep apnea (OSA), a modifiable contributor to impaired nighttime BP regulation, commonly co-occurs with hypertension. Primary care (PC) represents a strategic setting for their integrated management. The METASLEEP study aims to develop, implement, and evaluate a novel PC-based hypertension care model incorporating OSA diagnosis, treatment, and home monitoring to improve BP control.Objectives: To describe the rationale, design, methodology, and baseline participant characteristics of the 2024 initiation phase of the METASLEEP trial.Material and methods: Prospective, longitudinal, real-world implementation study conducted across 10 Spanish regions (ClinicalTrials.gov NCT05986487). Adults with hypertension and no prior OSA diagnosis undergo 24-h ambulatory BP monitoring (ABPM) in PC (target n = 1523). Participants with nocturnal hypertension and/or non-dippers receive PC-led OSA diagnostic testing, treatment, and home monitoring via an under-mattress sensor. Follow-ups at 6 and 12 months evaluate changes in nighttime BP (primary) and other clinical outcomes. Results: By end of 2024, 553 patients completed baseline ABPM. Of these, 288 (52.1%) showed nocturnal BP abnormalities: 248 (44.8%) had nocturnal hypertension and 211(38.4%) were non-dippers. Participants were middle-aged, overweight, and frequently had comorbid dyslipidemia, obesity, and diabetes. OSA prevalence was 22.6% mild, 34.1% moderate, and 35.3% severe. CPAP treatment was initiated in 79.4% of moderate-to-severe cases.Conclusions: METASLEEP introduces a novel PC-based model integrating OSA diagnosis and management within hypertension care. Early data reveal notably high prevalence of undiagnosed OSA in hypertensive patients.
KW - Cardiovascular disease
KW - High blood pressure
KW - Hypertension
KW - Implementation trial
KW - Non-dipping blood pressure
KW - Obstructive sleep apnea
UR - http://www.scopus.com/inward/record.url?scp=105024197360&partnerID=8YFLogxK
U2 - 10.1016/j.opresp.2025.100522
DO - 10.1016/j.opresp.2025.100522
M3 - Article
AN - SCOPUS:105024197360
SN - 2659-6636
VL - 8
JO - Open Respiratory Archives
JF - Open Respiratory Archives
IS - 1
M1 - 100522
ER -