Disturbed Sleep as a Mechanism of Race Differences in Nocturnal Blood Pressure Non-Dipping.

Abstract

Disturbed sleep may be a mechanism of race differences in nocturnal blood pressure non-dipping. In support of this proposal, we summarize recent research from three literatures: (1) race differences (Black compared with White individuals) in nocturnal blood pressure non-dipping, (2) the association between disturbed sleep and nocturnal blood pressure non-dipping, and (3) race differences in disturbed sleep. Black individuals are nearly twice as likely to have blood pressure non-dipping profiles compared with White individuals. This may be explained, in part, by sleep; shorter sleep duration, greater sleep fragmentation, less slow-wave sleep, and obstructive sleep apnea have each been associated with nocturnal blood pressure non-dipping. These sleep disturbances, in turn, are more common in Black compared with White individuals. Studies focused on nocturnal blood pressure non-dipping rarely assess sleep, and experimental evidence linking disturbed sleep with nocturnal blood pressure non-dipping in Black individuals is lacking. While mounting evidence from independent literatures suggests that disturbed sleep is a plausible, modifiable mechanism of race differences in nocturnal blood pressure non-dipping, definitive conclusions are premature given the current state of science.