Department of Respiratory Medicine.
Center for Genomic Medicine.
J Hypertens. 2018 Nov;36(11):2185-2192. doi: 10.1097/HJH.0000000000001802.
Abnormalities in circadian blood pressure (BP) variation, particularly increase in nocturnal BP, have been reported to be risk factors for cardiovascular disease, although the factors associated with BP abnormalities are not fully understood. This study aimed to clarify possible associations of sleep characteristics, including sleep fragmentation, sleep disordered breathing, and nocturia, with sleep BP by simultaneous multiday measurements.
A cross-sectional study evaluated 5959 community participants having home-measured data on nocturnal BP change (sleep BP - awaking BP), sleep characteristics, and sleep disordered breathing. Sleep characteristics including the fragmentation index were assessed using wrist-wearable actigraphy, whereas sleep disordered breathing was assessed by 3% oxygen desaturation index obtained using a finger-type monitor. The number of nocturnal urinations was recorded in a sleep diary.
Mean nocturnal SBP change was -8.5 ± 7.9%. A 3% oxygen desaturation index was associated with the BP change independently of the basic covariates (β = 0.051, P = 0.001), although the association became insignificant (P = 0.196) after adjusting the fragmentation index (β = 0.105, P < 0.001). The association of the fragmentation index was also insignificant (P = 0.153) after adjusting measurement season (middle season: β = 0.163, P < 0.001; summer season: β = 0.249, P < 0.001). In contrast, the frequency of urination showed strong and independent association (β = 0.140, P < 0.001), with smaller nocturnal BP drop in participants with frequent urination.
Subjective sleep estimates and frequent nocturnal urination may represent a potential risk for circadian BP abnormalities.
尽管人们尚未完全了解与血压异常相关的因素，但已有研究报道，昼夜血压（BP）变化异常，尤其是夜间 BP 升高，是心血管疾病的危险因素。本研究旨在通过同时进行多日测量来阐明睡眠特征（包括睡眠片段化、睡眠呼吸紊乱和夜间尿频）与睡眠 BP 之间可能存在的关联。
采用横断面研究方法，评估了 5959 名社区参与者的夜间 BP 变化（睡眠 BP-觉醒 BP）、睡眠特征和睡眠呼吸紊乱的家庭测量数据。使用腕戴式活动记录仪评估睡眠特征，包括片段指数，而使用指夹式监测仪获得的 3%氧减指数评估睡眠呼吸紊乱。在睡眠日记中记录夜间排尿次数。
平均夜间 SBP 变化为-8.5±7.9%。3%氧减指数与 BP 变化独立相关，不受基本协变量的影响（β=0.051，P=0.001），但在调整片段指数后，该关联变得无统计学意义（P=0.196）（β=0.105，P<0.001）。调整测量季节后，片段指数的关联也无统计学意义（P=0.153）（中季：β=0.163，P<0.001；夏季：β=0.249，P<0.001）。相比之下，排尿频率显示出强烈且独立的关联（β=0.140，P<0.001），频繁夜间排尿的参与者夜间 BP 下降幅度较小。
主观睡眠评估和频繁夜间尿频可能是昼夜 BP 异常的潜在危险因素。
