Eissa M A, Poffenbarger T, Portman R J
Department of Pediatrics, Medical School, University of Texas-Houston, 77030, USA.
Blood Press Monit. 2001 Feb;6(1):21-5. doi: 10.1097/00126097-200102000-00004.
Assessment of 24-h changes in blood pressure is one of the unique features that ambulatory blood pressure monitoring (ABPM) can provide. Most studies agree that sleep/wake periods should be based on patients' actual sleep and wake times. Actual wake and sleep time determinations are often based on patients' diary information. Several publications indicate that actigraphy is, at least, as accurate as activity diary in determining sleep/wake periods.
To compare subjects' compliance with actigraphy and diary keeping and to compare actigraphy and diary data in determination of sleep and wake times, mean blood pressures, classification of hypertension, and assessment of nocturnal dipping status.
We evaluated ABPM studies of 62 subjects. Blood pressure data were obtained using Spacelabs monitors for 24h. Sleep and wake times were determined by both the actigraph and patients' activity diary.
In the 62 studies, 56 subjects had successful actigraphy (90%), 44 had activity diary completion (71%), and 38 subjects had both (61%). There was no statistically significant difference between the mean wake and sleep onset using the two methods, but up to 3 hours' difference in wake or sleep onset was noted in some studies. Although the two methods did not significantly affect the calculated systolic blood pressure (SBP) or diastolic blood pressure (DBP) loads in either awake or sleep periods, approximately 55% of the subjects' dipping status was changed when diary information on sleep time was used compared to actigraph.
Our data indicate that in children and young adults, compliance with the actigraph was superior to diary completion and use of the actigraphy method rather than diary information changed the interpretation of some ABPM data. Our study suggested that actigraphy is superior to diary keeping in providing the information needed for appropriate interpretation of some ABPM data.
评估血压的24小时变化是动态血压监测（ABPM）所能提供的独特功能之一。大多数研究认为，睡眠/清醒时段应基于患者的实际睡眠和清醒时间。实际清醒和睡眠时间的确定通常基于患者的日记信息。有几份出版物表明，在确定睡眠/清醒时段方面，活动记录仪至少与活动日记一样准确。
比较受试者对活动记录仪和日记记录的依从性，并比较活动记录仪和日记数据在确定睡眠和清醒时间、平均血压、高血压分类以及夜间血压下降状态评估方面的差异。
我们评估了62名受试者的ABPM研究。使用太空实验室监测仪获取24小时血压数据。睡眠和清醒时间通过活动记录仪和患者的活动日记来确定。
在62项研究中，56名受试者成功使用了活动记录仪（90%），44名完成了活动日记（71%），38名受试者两者都完成了（61%）。两种方法确定的平均清醒和入睡时间之间没有统计学上的显著差异，但在一些研究中，清醒或入睡时间相差多达3小时。虽然两种方法在清醒或睡眠时段对计算出的收缩压（SBP）或舒张压（DBP）负荷没有显著影响，但与活动记录仪相比，使用睡眠日记信息时，约55%的受试者的血压下降状态发生了变化。
我们的数据表明，在儿童和年轻人中，对活动记录仪的依从性优于日记记录，并且使用活动记录仪方法而非日记信息改变了一些ABPM数据的解读。我们的研究表明，在提供适当解读某些ABPM数据所需信息方面，活动记录仪优于日记记录。
