Antihypertensive medication prior to nocturnal sleep reduces the risk of new-onset type 2 diabetes in hypertensive patients: a role for slow-wave sleep?

Benedict, Christian

doi:10.1007/s00125-015-3791-5

Cited by 3 publications

(2 citation statements)

References 10 publications

(9 reference statements)

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“…In a previous study, as SWS increased, the HOMA-IR index significantly decreased, suggesting that it has a significant effect on improving IR. 37 Benedict 38 and Hermida 39 theorized that the reduced risk for new-onset type 2 diabetes mellitus in patients with hypertension observed with bedtime ingestion of angiotensin-converting enzyme inhibitors was partially mediated by improvement in SWS. Endocrine metabolism is regulated by sleep and the circadian rhythm.…”

Section: Discussionmentioning

confidence: 99%

Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Huang

Liu

Wang

et al. 2021

NSS

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Objective Slow-wave sleep (SWS) and obstructive sleep apnea (OSA) have attracted recent research attention. However, their joint effects on insulin resistance (IR) remain unclear. This study explored whether SWS influences the relationship between OSA and IR. Methods We enrolled potential participants in our sleep center from 2007 to 2019. We collected demographic and clinical characteristics and determined IR status. SWS was derived from polysomnography data. Logistic regression analysis was used to reveal the associations between SWS and IR. Results In all, 6966 participants (5709 OSA and 1257 primary snoring [PS] subjects) were enrolled. Less SWS increased the risk of IR in OSA patients but not in PS patients. OSA patients with SWS <6.5% were more likely to have IR than were those with SWS >21.3%. OSA was an independent risk factor for IR after adjusting for potential confounding factors. In stratified analyses according to the percentage of SWS, OSA patients with SWS <6.5% had an odds ratio for IR of 2.461 (95% CI, 2.018–3.002) compared to the PS group after adjusting for potential confounders. Conclusion Less SWS is associated with higher odds for IR in OSA patients but not in PS patients. OSA is independently associated with IR. In addition, OSA combined with an extreme lack of SWS has a more harmful effect on the status of IR than OSA itself.

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Section: Discussionmentioning

confidence: 99%

Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Huang

Liu

Wang

et al. 2021

NSS

View full text Add to dashboard Cite

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“…The advanced model further included BMI, hypertension status, hypertension treatment, diabetes status, smoking status, alcohol consumption, leisure time physical activity, history of myocardial infarction or heart failure, and reports of frequent use of hypnotics. Note that our assumptions regarding dependencies between predictor, outcome, and confounder variables were based on data from the published literature 15 – 18 . Overall, a two-sided P value of less than 0.05 was regarded as statistically significant.…”

Section: Methodsmentioning

confidence: 99%

Self-reported difficulty initiating sleep and early morning awakenings are associated with nocturnal diastolic non-dipping in older white Swedish men

Tan

Lind

Ingelsson

et al. 2020

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Chronically blunted nocturnal blood pressure (BP) dipping has been shown to increase the future risk of cardiovascular diseases. In the present cross-sectional study, we investigated whether selfreported insomnia symptoms were associated with an altered 24-h BP profile and blunted nocturnal BP dipping (night-today BP ratio > 0.90) in older men. For the analysis, we used 24-h ambulatory blood pressure data and reports of insomnia symptoms (difficulty initiating sleep, DIS; and early morning awakenings, EMA) from 995 Swedish men (mean age: 71 years). Compared to men without DIS, those reporting DIS (10% of the cohort) had a higher odds ratio of diastolic non-dipping (1.85 [1.15, 2.98], P = 0.011). Similarly, men who reported EMA (19% of the cohort) had a higher odds ratio of diastolic non-dipping than those without EMA (1.57 [1.09, 2.26], P = 0.015). Despite a slightly higher nocturnal diastolic BP among men with EMA vs. those without EMA (+ 1.4 mmHg, P = 0.042), no other statistically significant differences in BP and heart rate were found between men with and those without insomnia symptoms. Our findings suggest that older men reporting difficulty initiating sleep or early morning awakenings may have a higher risk of nocturnal diastolic non-dipping. Our findings must be replicated in larger cohorts that also include women.

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Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea in Prevalent Hypertension

et al. 2020

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Due to frequent abnormal breathing events and their effects on sleep architecture, patients with obstructive sleep apnea (OSA) exhibit decreased amounts of slow wave sleep (SWS). Reduced SWS has been linked to hypertension in community-based studies. We sought to investigate whether SWS percentage modifies the association between OSA and prevalent hypertension. We studied 7107 patients with OSA and 1118 primary snorers who underwent in-laboratory polysomnography. Patients were classified into quartiles of percent SWS. Hypertension was defined based either on clinic blood pressure measures or on physician diagnosis. Multivariable logistic regression model showed a significant interaction effect of OSA and SWS on prevalent hypertension ( P =0.002). Decreased SWS was associated with higher odds for hypertension in OSA but not in primary snoring, with patients with OSA exhibiting <0.1% SWS (OR, 1.44 [95% CI, 1.21–1.70]; P =0.001) and those with 0.1% to 4.8% SWS (OR, 1.20 [95% CI, 1.03–1.40]; P =0.02) being more likely to have hypertension compared with those with >11.1% SWS. In analysis stratified by OSA severity, significant associations between percent SWS and blood pressure emerged only in moderate and severe OSA. Effect modifications by sex ( P =0.040) and age ( P =0.007) were also only evident in OSA, indicating that decreased SWS was associated with hypertension only in men and in patients <60 years old. Decreased SWS is associated with a dose-dependent increase in odds of prevalent hypertension in patients with OSA. The effects of SWS are likely to be modulated by OSA severity. SWS may be implicated in the heightened risk of cardiovascular diseases exhibited by patients with OSA.

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Antihypertensive medication prior to nocturnal sleep reduces the risk of new-onset type 2 diabetes in hypertensive patients: a role for slow-wave sleep?

Cited by 3 publications

References 10 publications

Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Self-reported difficulty initiating sleep and early morning awakenings are associated with nocturnal diastolic non-dipping in older white Swedish men

Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea in Prevalent Hypertension

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