IMPACT OF AMBULATORY BLOOD PRESSURE MONITORING ON SLEEP QUALITY AND BLOOD PRESSURE: PP.3.127

Abstract

Objective: During nocturnal non-invasive ambulatory blood pressure monitoring (ABPM), inevitably an undesirable external stimulus due to pump noise and pressure produced by cuff inflation may affect the quality of sleep, influence the physiological nocturnal blood pressure fall and consequently affect dipping status. We sought to investigate whether blood pressure monitoring provokes awakenings and changes in sleep quality, blood pressure and/or heart rate. Design and Method: The study population consisted of 108 consecutive subjects with stage I-II essential hypertension (aged 54 ± 9 years, 59 male, office BP = 148/97 mm Hg). Participants were divided into two groups according to whether they underwent ambulatory blood pressure monitoring (group A, n = 60), or not (group B, n = 48). Repeated measurements of blood pressure were registered with non-invasive automatic blood pressure monitors (Spacelabs 90207, Welch Allyn 6100S devices) every 20 min. Self-reported data regarding the quality of sleep, numbers and duration of arousal were obtained via standardized questionnaire. Results: Group A compared to group B demonstrated a small but significant increase in the number of nocturnal awakenings (2.8 vs 1.2, p = 0.045), although their duration did not significantly differ (p = NS). However, the two groups exhibited similar mean values of nocturnal blood pressure and heart rate (121/73 vs 119/71 mm Hg, 67 vs 65 beats/min, p = NS in both cases). The reported sleep quality did not differ between the two groups but both sleep quality and higher numbers of awakenings (>3) were associated with non-dipping status (p < 0.05, in both cases). Conclusions: Our findings indicate that even though ambulatory blood pressure monitoring induces modest sleep disturbances, it can accurately evaluate night time blood pressure profile and heart rate, without affecting sleep efficiency and quality. Sleep evaluation may be particularly useful in essential hypertension, as poor quality of nocturnal sleep was associated with non-dipping status.