Abstract 10574: Disrupted Sleep is Associated With Increased 24-Hour Systolic Blood Pressure Variability in Caregivers

Abstract

Introduction. A growing body of research shows an association between caregiving and increased cardiovascular disease (CVD) risk. Blood pressure variability (BPV) is known as a surrogate marker of CVD development. However, BPV in caregivers has rarely been used to assess for CVD risk, especially in relation to psychological and behavioral factors. The purpose of this study was to examine the associations of psychological symptoms (i.e., caregiving burden and depressive symptoms) and sleep quality with 24-hour BPV among caregivers of individuals with chronic illness. Methods. Thirty caregivers (25 female; 27 non-Hispanic white; mean age 62 years) who provided in-home care were recruited from the community in this cross-sectional study. Caregiver demographic data, caregiving stress (Zarit Burden Interview), and depressive symptoms (Patient Health Questionnaire-9) were obtained. Sleep quality (i.e., sleep efficiency, wake after sleep onset, the number of awakenings) was assessed using an actigraph for 7 consecutive days. Systolic and diastolic BPV over 24 hours, while awake (daytime), and while sleeping (night time) were obtained by ambulatory BP monitoring. Pearson's correlations and multiple linear regression were conducted to examine associations of psychological symptoms and sleep quality with BPV. Results. Sleep efficiency was negatively correlated with diastolic BPV while awake ( r = -0.368, p = 0.045). The number of awakenings during sleep was positively correlated with systolic BPV while awake ( r = 0.426, p = 0.019) and diastolic BPV while awake ( r = 0.422, p = 0.020). Caregiving stress and depression were not correlated with BPV. After controlling for age and mean arterial pressure, the number of awakenings was associated with increased systolic BPV over 24 hours ( B = 0.194, p = 0.018) and systolic BPV while awake ( B = 0.280, p = 0.002), respectively. Conclusion. Caregivers’ disrupted sleep represented by frequent awakenings may play a role in increased CVD risk as evidenced by increased BPV. While future large clinical studies should be conducted to confirm these findings, improving sleep quality would need to be considered for CVD prevention strategies for caregivers.