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.
Matthews
Karen A
KA
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. matthewska@upmc.edu
Kamarck
Thomas W
TW
H Hall
Martica
M
Strollo
Patrick J
PJ
Owens
Jane F
JF
Buysse
Daniel J
DJ
Lee
Laisze
L
Reis
Steven E
SE
D001741:Black or African American; D000368:Aged; D001143:Arousal; D001794:Blood Pressure; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000208:ethnology* / Q000503:physiopathology*; D012895:Sleep, REM; D044465:White People