Is obstructive sleep apnoea the most important determinant of reverse dipping? Hypothesis and evidence.

From the physiopathological point of view obstructive sleep apnoea (OSA) should be regarded as the phenotype with the highest potential to disrupt the normal circadian blood pressure (BP rhythm). Despite these assumptions, it is surprising, however, to note that the data supporting a link between OSA and paradoxical increase in nighttime BP (ie, the so-called reverse dipping pattern) are still very limited and in some ways not entirely consistent. Available evidence on the association between OSA and reverse dipping (RD pattern), contrary to what is commonly thought, is still scanty. Given the potential negative synergistic effect of these two conditions, it is essential to have studies targeting this topic available soon.