Matthews Karen A, Kamarck Thomas W, H Hall Martica, Strollo Patrick J, Owens Jane F, Buysse Daniel J, Lee Laisze, Reis Steven E
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Hypertens. 2008 Jul;21(7):826-31. doi: 10.1038/ajh.2008.183. Epub 2008 May 15.
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.
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 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.
Findings are consistent with the hypothesis that elevated night time/daytime pressure may be a consequence of poor sleep.
夜间/日间血压（BP）比值升高与心血管疾病的发病率和死亡率相关。我们评估了睡眠/清醒血压比值与睡眠障碍之间的关联。
通过在家中进行九天的活动记录仪和日记测量以及两晚的多导睡眠图（PSG）评估睡眠障碍；动态血压测量至少48小时。参与者为186名中年非裔美国人和白人男性及女性，他们没有心肌梗死、中风、介入心脏病学手术史、糖尿病，也未被诊断出患有呼吸暂停或其他睡眠障碍。
结果显示，血压的睡眠/清醒比值越高，睡眠越碎片化，浅睡眠（1期）比例越大，快速眼动（REM）睡眠比例越小，睡眠中觉醒次数越多。这些结果不受年龄、种族、性别、弗雷明汉风险状态、心血管药物、体重指数和呼吸暂停/低通气指数的影响。心理社会压力指标在睡眠/清醒血压比值较高的人群中并不更高。
研究结果与夜间/日间血压升高可能是睡眠不佳所致这一假设一致。
