Abstract P098: Association Between Postpartum Sleep Characteristics And Twenty-four Hour Blood Pressure Patterns In Women With And Without A History Of Preeclampsia

Abstract

Introduction: Women with a history of preeclampsia (hxPE), a hypertensive pregnancy disorder, are at a four-fold elevated risk of chronic hypertension postpartum compared with healthy pregnancy. The postpartum period is particularly vulnerable to adverse sleep characteristics such as poor sleep quality and frequent sleep disturbances, which are associated with hypertension risk. However, the relation between postpartum sleep characteristics, nighttime blood pressure (BP) and diurnal BP variation assessed by twenty-four hour ambulatory BP monitoring is not well-studied. Methods: Women with a hxPE (N=13, age 37 ± 5 years) and healthy pregnancy controls (N=12, 36 ± 3 years) without history of sleep disorders were enrolled between 1-5 years postpartum (2.9 ± 1.3 years). Subjective sleep characteristics were reported using the Pittsburgh Sleep Quality Index (PSQI). Ambulatory BP monitoring was conducted to measure 24-hour, day and night BP as well as nocturnal BP dipping and morning BP surge quantified by sleep-trough surge. Results: Women with a hxPE tended to report poorer global sleep quality (7 ± 3 vs 5 ± 3 PSQI score, P=0.09) related to more frequent sleep disturbance (8 ± 4 vs 5 ± 3 score, P=0.053) without differences in habitual sleep duration (7 ± 1 vs 7 ± 1 hours, P=0.37) or sleep latency (18 ± 11 vs 17 ± 9 min, P=0.89). In the entire group, frequency of sleep disturbance was associated with greater 24-hour BP (systolic: r = 0.42, P=0.046; diastolic: r = 0.43, P=0.04) but not night BP (systolic: r = 0.19, P=0.40; diastolic: r = 0.19, P=0.40). Only sleep latency was related to blunted nocturnal BP dipping % (r = -0.38, P=0.08), and no sleep characteristics were associated with augmented morning BP surge. Conclusions: Women with a hxPE reported poorer overall sleep quality compared with healthy pregnancy controls 1-5 years postpartum, particularly frequent sleep disturbances. Frequency of sleep disturbance was associated with elevated 24-hour BP, but not higher nighttime BP or attenuated nocturnal BP dipping, indicating that the impact of postpartum sleep characteristics on BP is not attributable to diurnal BP variation.