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照料者睡眠紊乱与 24 小时血压变异性的关联。

Association of disrupted sleep with 24-hour blood pressure variability in caregivers.

机构信息

School of Nursing, Vanderbilt University, Nashville, TN, USA.

School of Nursing, University of Virginia, Charlottesville, VA, USA.

出版信息

Heart Lung. 2023 Jul-Aug;60:45-51. doi: 10.1016/j.hrtlng.2023.02.024. Epub 2023 Mar 9.

DOI:10.1016/j.hrtlng.2023.02.024
PMID:36905754
Abstract

BACKGROUND

A growing body of research highlights the negative impact of caregiving on cardiovascular disease (CVD) risk.

OBJECTIVES

This study aimed to examine associations of psychological symptoms and sleep quality with 24-hour blood pressure variability (BPV), which is an independent predictor of CVD, among family caregivers of community-dwelling individuals with chronic illness.

METHODS

For this cross-sectional study, we assessed caregiving burden and depressive symptoms using questionnaires and 7-day sleep quality (i.e., number of awakenings, wake after sleep onset, sleep efficiency) using an actigraph. The participants carried out a 24-hour ambulatory BP monitoring for systolic and diastolic BPV over 24 h and during awake/sleep times. We performed Pearson's correlations and multiple linear regression.

RESULTS

The analytic sample consisted of 30 caregivers (25 female; mean age 62 years). The number of awakenings during sleep was positively correlated with systolic BPV-awake (r = 0.426, p = 0.019) and diastolic BPV-awake (r = 0.422, p = 0.020). Sleep efficiency was negatively correlated with diastolic BPV-awake (r = -0.368, p = 0.045). Caregiving burden and depressive symptoms were not correlated with BPV. After controlling for age and mean arterial pressure, the number of awakenings was significantly associated with increased systolic BPV-24 h (β = 0.194, p = 0.018) and systolic BPV-awake (β = 0.280, p = 0.002), respectively.

CONCLUSIONS

Caregivers' disrupted sleep may play a role in increased CVD risk. While these findings should be confirmed in large clinical studies, improving sleep quality would need to be considered in CVD prevention for caregivers.

摘要

背景

越来越多的研究强调了照顾者对心血管疾病 (CVD) 风险的负面影响。

目的

本研究旨在检查心理症状和睡眠质量与 24 小时血压变异性 (BPV) 之间的关系,BPV 是 CVD 的独立预测因素,研究对象为社区居住的慢性病患者的家庭照顾者。

方法

在这项横断面研究中,我们使用问卷评估了照顾者负担和抑郁症状,使用活动记录仪评估了 7 天的睡眠质量(即觉醒次数、睡眠起始后觉醒、睡眠效率)。参与者进行了 24 小时动态血压监测,以了解 24 小时和清醒/睡眠期间的收缩压和舒张压 BPV。我们进行了 Pearson 相关分析和多元线性回归。

结果

分析样本包括 30 名照顾者(25 名女性;平均年龄 62 岁)。睡眠期间的觉醒次数与清醒时收缩压 BPV(r = 0.426,p = 0.019)和清醒时舒张压 BPV(r = 0.422,p = 0.020)呈正相关。睡眠效率与清醒时舒张压 BPV 呈负相关(r = -0.368,p = 0.045)。照顾者负担和抑郁症状与 BPV 无关。在校正年龄和平均动脉压后,觉醒次数与 24 小时收缩压 BPV(β=0.194,p=0.018)和清醒时收缩压 BPV(β=0.280,p=0.002)显著相关。

结论

照顾者睡眠中断可能在增加 CVD 风险中起作用。虽然这些发现需要在大型临床研究中得到证实,但在照顾者的 CVD 预防中需要考虑改善睡眠质量。

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