Influence of Quality of Sleep on the Nocturnal Decline in Blood Pressure During Ambulatory Blood Pressure Monitoring

Alessi, Alexandre; Alessi, C; Piana, Edson Rogério; Assis, Márcia; Oliveira, Luciano Rodrigo; Cunha, Cristiane Martins

doi:10.1590/s0066-782x2002000200010

Cited by 17 publications

(13 citation statements)

References 42 publications

(52 reference statements)

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“…We found that the effects of ABPM on subjective sleep quality did not differ between dippers and nondippers, suggesting no association between subjective sleep quality and blood pressure drop during sleep, in agreement with a study by Alessi et al [29].…”

Section: Discussionsupporting

confidence: 93%

Different effects of ambulatory blood pressure monitoring on subjective and objective sleep quality

Tropeano

Roudot‐Thoraval

Badoual

et al. 2006

Blood Pressure Monitoring

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Section: Discussionsupporting

confidence: 93%

Different effects of ambulatory blood pressure monitoring on subjective and objective sleep quality

Tropeano

Roudot‐Thoraval

Badoual

et al. 2006

Blood Pressure Monitoring

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“…Obviously, the higher the number of ambulatory readings obtained, the more representative a recording is for an individual's blood pressure level. However, cuff inflations during intermittent ambulatory blood pressure monitoring causes muscle compression, pain or discomfort at the arm [25][26][27], disturbs sleep [6,[28][29][30], and therefore potentially affects the accuracy of blood pressure assessment [29,30], especially in hypertensive patients [27] or patients with sleeping disorders [29]. Cuff inflations can be extremely annoying in shift workers during the transition periods from daytime to nighttime work or in assemblyline workers, who have to keep up with an imposed production rhythm.…”

Section: Discussionmentioning

confidence: 99%

Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure level in research settings: an analysis of the IDACO database

et al. 2018

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, we randomly selected a certain number of readings (from 30 to 1 awake and 10 to 1 asleep readings) at a time over 1000 bootstraps at each step. We evaluated: (i) concordance of the ABP level; (ii) consistency of the cross-classification based on office blood pressure and ABP; and (iii) accuracy in predicting cardiovascular complications. For each criterion, we fitted a regression line joining data points relating outcome to the number of readings covering the ranges of 30-20/10-7 for awake/ asleep readings. Results: Reducing readings widened the SD of the systolic/diastolic differences between full (reference) and selected recordings from 1.7/1.2 (30 readings) to 14.3/10.3 mm Hg (single reading) during wakefulness, and from 1.9/1.4 to 10.3/7.7 mm Hg during sleep; lowered the j statistic from 0.94 to 0.63, and decreased the hazard ratio associated with 10/5 mm Hg increments in systolic/diastolic ABP from 1.21/1.14 to 1.06/1.04 during wakefulness and from 1.26/1.17 to 1.14/1.08 during sleep. The first data points falling off these regression lines during wakefulness/sleep corresponded to 8/3 and 8/4 readings for criteria (i) and (iii) and to 5 awake readings for criterion (ii). Conclusions: 24-h ambulatory recordings with !8/!4 awake/asleep readings yielded ABP levels similar to recordings including the guideline-recommended !20/!7 readings. These criteria save valuable data in a research setting, but are not applicable to clinical practice.

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“…Currently, ABPM is considered as the gold standard for NBP measurement [20,25]. However, this seemingly perfect method for NBP measurement has its own limitations, for example, disturbing sleep quality [26], high cost, and inconvenience of performing multiple measurements. The feasibility of obtaining other NBP measurement methods has been investigated widely, especially using home-monitoring devices.…”

Section: Discussionmentioning

confidence: 99%

Estimate of nocturnal blood pressure and detection of non-dippers based on clinical or ambulatory monitoring in the inpatient setting

Zhang

Tan

2013

BMC Cardiovasc Disord

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BackgroundAmbulatory blood pressure monitoring is regarded as the gold standard for monitoring nocturnal blood pressure (NBP) and is usually performed out of office. Currently, a novel method for monitoring NBP is indispensible in the inpatient setting. The widely used manual BP monitoring procedure has the potential to monitor NBP in the hospital setting. The feasibility and accuracy of manual sphygmomanometer to monitor NBP has not been explored widely.MethodsA cross-sectional study was conducted at the cardiology department of a university-affiliated hospital to study patients with mild-to-moderate essential hypertension. One hundred and fifty-five patients were recruited to compare BP derived from a manual device and ambulatory BP monitoring (ABPM). The manual BP measurement was performed six times at 22:00, 02:00, 06:00, 10:00, 14:00 and 18:00 h. The measurements at 22:00, 02:00 and 06:00 h were defined as night-time and the others as daytime. ABPM was programmed to measure at 30-min intervals between measurements.ResultsAll-day, daytime and night-time BP did not differ significantly from 24-h ambulatory systolic BP [all-day mean difference −0.52±4.67 mmHg, 95% confidence interval (CI) –1.26 to 0.22, P=0.168; daytime mean difference 0.24±5.45 mmHg, 95% CI −0.62 to 1.11, P=0.580; night-time mean difference 0.30±7.22 mmHg, 95% CI −0.84 to 1.45, P=0.601) rather than diastolic BP. There was a strong correlation between clinical and ambulatory BP for both systolic and diastolic BP. On the basis of ABPM, 101 (65%) patients were classified as non-dippers, compared with 106 (68%) by manual sphygmomanometer (P<0.001).ConclusionsTraditional manual sphygmomanometer provides similar daytime and night-time systolic BP measurements in hospital. Moreover, the detection of non-dippers by manual methods is in good agreement with 24-h ABPM. Further studies are required to confirm the clinical relevance of these findings by comparing the association of NBP in the hospital ward assessed by manual monitoring with preclinical organ damage and cardiovascular and cerebrovascular outcomes.

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Influence of Quality of Sleep on the Nocturnal Decline in Blood Pressure During Ambulatory Blood Pressure Monitoring

Abstract: Objective -To assess the influence of the quality of sleep on the nocturnal physiological drop in blood pressure during ambulatory blood pressure monitoring. Methods -

Cited by 17 publications

References 42 publications

Different effects of ambulatory blood pressure monitoring on subjective and objective sleep quality

Different effects of ambulatory blood pressure monitoring on subjective and objective sleep quality

Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure level in research settings: an analysis of the IDACO database

Estimate of nocturnal blood pressure and detection of non-dippers based on clinical or ambulatory monitoring in the inpatient setting

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