24-hour ambulatory blood pressure monitoring did not adversely affect sleep quality, although sleep efficiency was lower in nondippers versus dippers (P=0.033) and in African-Americans (P=0.002).
Observational (n=121)
Does 24-hour ambulatory blood pressure monitoring adversely affect sleep quality in patients with untreated hypertension?
24-hour ambulatory blood pressure monitoring does not adversely affect objective sleep quality in patients with untreated hypertension, validating its use without concern for sleep disruption confounding the circadian BP profile.
BACKGROUND: The nondipping circadian blood pressure (BP) profile is associated with both poor sleep quality and increased cardiovascular risk. The present study aimed to clarify the potential confounding effects of 24-hour ambulatory blood pressure monitoring (ABPM) used to characterize the circadian BP profile by assessing its impact on sleep quality. METHODS: Participants were 121 middle-aged men and women with untreated hypertension (age = 46 ± 8 years; 43% women; 45% African-American). Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index. Wrist actigraphy was used to measure sleep quality objectively as sleep efficiency (SE) and total sleep time (TST) on 7 consecutive non-ABPM days (baseline) and 3 subsequent 24-hour ABPM days. RESULTS: Average ambulatory BP was 137.2 ± 10.8/84.3 ± 8.5 mm Hg during the day and 119.6 ± 12.4/69.5 ± 9.8 mm Hg at night. Using the criterion of <10% dip in systolic BP (SBP) to define nondippers, there were 40 nondippers (SBP dip = 7.3 ± 2.6%) and 81 dippers (SBP dip = 15.5 ± 3.4%). There was no effect of time on SE or TST over non-ABPM and ABPM days, suggesting that ABPM does not adversely affect sleep quality. Sleep quality was generally poorer (lower SE) in nondippers compared with dippers (P = 0.033), but differences were independent of whether or not participants were undergoing 24-hour ABPM. African-American race (P = 0.002) was also associated with lower SE. CONCLUSION: Sleep quality generally appears to be poor in men and women with untreated hypertension and especially among African-Americans. Importantly, for both dippers and nondippers, we found no evidence that ABPM had an adverse effect on sleep quality.
Sherwood et al. (Wed,) conducted a observational in Untreated hypertension (n=121). 24-hour ambulatory blood pressure monitoring (ABPM) vs. Non-ABPM days (baseline) was evaluated on Sleep quality measured objectively as sleep efficiency (SE) and total sleep time (TST). 24-hour ambulatory blood pressure monitoring did not adversely affect sleep quality, although sleep efficiency was lower in nondippers versus dippers (P=0.033) and in African-Americans (P=0.002).