Loredo José S, Nelesen Richard, Ancoli-Israel Sonia, Dimsdale Joel E
Department of Medicine, University of California, San Diego, 92103-0804, USA.
Sleep. 2004 Sep 15;27(6):1097-103. doi: 10.1093/sleep/27.6.1097.
To investigate the relationship between sleep quality and nocturnal blood pressure dipping in normal subjects. We hypothesized that sleep quality correlates with dipping.
Cross-sectional study.
Unattended polysomnography in the home followed by a 24-hour ambulatory blood pressure measurement.
Eighty-eight self-described normal subjects were evaluated; 26 were excluded due to an apnea-hypopnea index > or = 10. None were taking antihypertensive medications.
N/A.
Subjects were divided into dippers and nondippers based on > or = 10% drop in nocturnal mean arterial pressure (MAP). Sleep-quality variables included total sleep time; sleep latency; percentage of stages 1, 2, 3, 4, and rapid-eye-movement sleep; percentage of wake time after sleep onset (WASO); total arousal index; and sleep efficiency. Of the remaining 62 subjects, 17.7% were nondippers, and 7 were hypertensive. There was no difference in age, body mass index, apnea-hypopnea index, blood pressure, or sleep quality between groups. Stage 4 sleep correlated significantly with dipping of diastolic blood pressure and MAP (r = 0.410 and 0.378, respectively, P < or = .002), and percentage of WASO was negatively correlated with dipping of diastolic blood pressure (r = -0.360, P = .004), suggesting that greater dipping was associated with better sleep quality. On multivariate analyses, Stage 4 sleep was independently associated with dipping of diastolic blood pressure (P = .034) after adjusting for screening MAP, percentage of WASO, total arousal index, and Stage 1 sleep. The same link was found between Stage 4 sleep and dipping of MAP (P = .05) after adjusting for screening MAP, age, sex, and body mass index. Repeat analyses excluding hypertensives yielded similar findings.
Our data suggest that deeper and less-fragmented sleep is associated with more blood pressure dipping in normal subjects.
研究正常受试者睡眠质量与夜间血压下降之间的关系。我们假设睡眠质量与血压下降相关。
横断面研究。
在家中进行无人值守的多导睡眠图监测，随后进行24小时动态血压测量。
对88名自称正常的受试者进行评估；26名因呼吸暂停低通气指数≥10而被排除。无人服用抗高血压药物。
无。
根据夜间平均动脉压（MAP）下降≥10%，将受试者分为血压下降者和非血压下降者。睡眠质量变量包括总睡眠时间、睡眠潜伏期、1期、2期、3期、4期和快速眼动睡眠的百分比、睡眠开始后的觉醒时间百分比（WASO）、总觉醒指数和睡眠效率。在其余62名受试者中，17.7%为非血压下降者，7名患有高血压。两组在年龄、体重指数、呼吸暂停低通气指数、血压或睡眠质量方面无差异。4期睡眠与舒张压和MAP的下降显著相关（r分别为0.410和0.378，P≤0.002），WASO百分比与舒张压下降呈负相关（r=-0.360，P=0.004），表明更大程度的血压下降与更好的睡眠质量相关。多因素分析显示，在调整筛查MAP、WASO百分比、总觉醒指数和1期睡眠后，4期睡眠与舒张压下降独立相关（P=0.034）。在调整筛查MAP、年龄、性别和体重指数后，4期睡眠与MAP下降之间也发现了相同的联系（P=0.05）。排除高血压患者后进行的重复分析得出了类似的结果。
我们的数据表明，在正常受试者中，更深层次、更少碎片化的睡眠与更多的血压下降相关。
