title: Different effects of ambulatory blood pressure monitoring on subjective and objective sleep quality.
abstract: OBJECTIVE
  To determine whether ambulatory blood pressure monitoring affects objective and subjective sleep quality in patients tested at home.
  
  
  METHODS
  Seventy consecutive patients (40 women and 30 men, aged 53+/-15 years), having ambulatory blood pressure monitoring to monitor the efficacy of antihypertensive treatment or to distinguish between hypertension or white-coat hypertension had an evaluation of their sleep quality on a first night with ambulatory blood pressure monitoring and the three following nights without ambulatory blood pressure monitoring. Ambulatory blood pressure monitoring was performed with an auscultatory device with a measure every 15 min during 24 h. Sleep evaluation criteria were both subjective (sleep quality score and sleep questionnaire) and objective (wrist actigraphy monitoring). Sleep parameters during night 1 with ambulatory blood pressure monitoring were compared with those during night 4 without ambulatory blood pressure monitoring. Usual quality of sleep of the patients was assessed by the mean sleep quality score over 7 consecutive days.
  
  
  RESULTS
  The sleep quality score was significantly higher for night 4 than for night 1 (7.3+/-2.1 vs. 5.3+/-2.3; P<0.0001). In contrast, actigraphy parameters (actual sleep time, mean activity score, and fragmentation index) were similar on night 1 and night 4 (6.7+/-1.2 vs. 6.9+/-1.2, 13.2+/-9.8 vs. 12.1+/-8.4, and 31.0+/-14.5 vs. 29.9+/-14.3, respectively). Subjective sleep quality was significantly altered by ambulatory blood pressure monitoring in good sleepers (mean sleep quality score > or =7, 73% of patients) but not in poor sleepers. The effect of ambulatory blood pressure monitoring on subjective sleep quality did not differ between dippers and nondippers.
  
  
  CONCLUSIONS
  Objective sleep quality as assessed by wrist actigraphy is not significantly altered by ambulatory blood pressure monitoring, whereas subjective sleep quality is adversely affected in good sleepers.
authors.affiliation: Service de Pharmacologie Clinique, AP-HP, Hopital Henri Mondor, Créteil, France.
authors.forename: Anne-Isabelle
authors.initials: AI
authors.lastname: Tropeano
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Thierry
authors.initials: T
authors.lastname: Badoual
authors.forename: Françoise
authors.initials: F
authors.lastname: Goldenberg
authors.forename: Guillaume
authors.initials: G
authors.lastname: Dolbeau
authors.forename: Philippe
authors.initials: P
authors.lastname: Gosse
authors.forename: Isabelle
authors.initials: I
authors.lastname: Macquin-Mavier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015924:Blood Pressure Monitors; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000503:physiopathology*