title: A new diagnostic tool for masked hypertension: impaired sleep quality.
abstract: BACKGROUND
  The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension.
  
  
  METHODS
  A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI).
  
  
  RESULTS
  The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 ±2.43 vs. 2.33 ±1.67,p< 0.001). A PSQI score > 5 was found in 45.8% (n= 33) of patients in the masked hypertension group and 15% (n= 6) of patients in the normotensive group (p< 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n= 41) of the masked hypertension group (p< 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 ±3.21 vs. 3.58 ±2.33,p< 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI.
  
  
  CONCLUSIONS
  This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Erdem
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Cakır
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Yıldırım
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Alcelik
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Donmez
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Taha Can
authors.initials: TC
authors.lastname: Tuman
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Sabri Onur
authors.initials: SO
authors.lastname: Caglar
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Alim
authors.initials: A
authors.lastname: Erdem
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazıcı
keywords: masked hypertension; sleep disturbances; sleep quality