Relationship of Non-Dipper and Reverse-Dipper Pattern with Sleep Quality in Normotensive Patients

Abstract

It has been observed in many different populations that circadian blood pressure (BP) patterns have a significant impact on cardiovascular (CV) results. Important predictors of CV morbidity and mortality are known as non-dipper (ND) and reverse-dipper (RD) BP pattern. RD and ND patterns are frequently encountered in many normotensive patients in daily practice. Methods: The purpose of this study is to evaluate the frequency and quality of sleep, especially in normotensive young individuals, by using sleep questionnaires and to evaluate their relationship with poor BP patterns. A total of 195 normotensive patients (68 dippers, 63 ND, and 65 RD) were enrolled into this cross-sectional study. The insomnia severity index (ISI), Epworth sleepiness scale (ESS), and Pittsburgh sleep quality index (PSQI) approved questionnaires were applied to evaluate the presence and severity of sleep disorders and to determine the patient's sleep quality. Results: When dipper and ND groups were compared, significant differences were observed in ISI, ESS, and PSQI (p<0.001). Then, the study patients were re-evaluated as dipper, ND, and RD groups and seen this significant difference continued (p<0.001). Also, the sleep time was significantly different between all groups of dipper (7.23±0.11 hours), ND (6.72±0.15 hours), and RD (5.79±0.11 hours) (p<0.001). In the correlation analysis, a significant inverse relationship was observed between sleep time and all survey results (p<0.05). Conclusions: RD and ND patterns are associated with sleep quality in healthy individuals. It is necessary to evaluate patients with RD and ND BP patterns in normotensive individuals in terms of sleep disorders in detail.

Blunted circadian variation of blood pressure in individuals with neurofibromatosis type 1

“…This could be due to a higher mean body mass index of the cohort (around 29 kg/m 2 ) and the presence of different comorbidities (diabetes, thyroid dysfunction and dyslipidemia) in 29% of individuals, which are known to reduce the nocturnal decline in BP [ 23 , 37 ]. In this study, they also observed significant differences in sleep time and sleep quality among “dippers”, “non-dippers” and “risers” [ 18 ]. Reduce sleep time was associated with decreased nocturnal systolic BP variability and riser profile [ 18 ].…”

“…In this study, they also observed significant differences in sleep time and sleep quality among “dippers”, “non-dippers” and “risers” [ 18 ]. Reduce sleep time was associated with decreased nocturnal systolic BP variability and riser profile [ 18 ]. Several studies have previously described the impact of sleep troubles on circadian BP [ 38 , 39 ].…”

Prediction of atrial fibrillation in patients with hypertension: A comprehensive comparison of office and ambulatory blood pressure measurements

“…38,39 The reverse dipping pattern is adversely associated with sleep quality and time. 42 Some studies discovered that a reverse dipping pattern was more likely to be associated with obstructive sleep apnea, 43,44 and sleep fragmentation, and intermittent hypoxia might trigger sympathetic activity and result in elevated BP at night. 45 In a retrospective cohort study, obstructive sleep apnea was a significant predictor of AF incidence (HR 2.18, 95% CI: 1.34-3.54).…”