Blood Pressure Dipping and Sleep Disturbance in African-American and Caucasian Men and Women

BACKGROUND: Elevated night time/daytime blood pressure (BP) ratios are associated with cardiovascular morbidity and mortality. We evaluated the associations between sleep/awake BP ratios and sleep disturbances. METHODS: Sleep disturbances were assessed by in-home actigraphy and diary measures for nine nights, and polysomnography (PSG) for two nights; ambulatory BP was measured for at least 48 h. Participants were 186 middle-aged African-American and Caucasian men and women who were free from prevalent myocardial infarction, stroke, history of interventional cardiology procedures, diabetes, and diagnosed apnea or other sleep disorders. RESULTS: Results showed that the greater the sleep/wake ratios of BP, the more fragmented the sleep, the greater the proportion in stage 1 (light) sleep and the smaller the proportion in rapid eye movement (REM) sleep, and the greater the number of arousals from sleep. These results were independent of age, race, gender, Framingham Risk status, cardiovascular medications, body mass index, and apnea/hypopnea index. Indicators of psychosocial stress were not greater among those with higher sleep/wake BP ratios. CONCLUSIONS: Findings are consistent with the hypothesis that elevated night time/daytime pressure may be a consequence of poor sleep.