Sleep quality among relatively younger patients with initial diagnosis of hypertension: Dippers versus non‐dippers

Yılmaz, Mehmet; Yalta, Kenan; Turgut, Okan Onur; Yılmaz, Ahmet; Yücel, Oğuzhan; Bektaşoğlu, Gökhan; Tandoğan, İzzet

doi:10.1080/08037050701343225

Cited by 47 publications

(39 citation statements)

References 14 publications

(16 reference statements)

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“…19,26,36 Nevertheless, several studies reported that there was an association between non-dipper status, which was defined as blood pressure drop less than 10% during sleep, and sleep quality using the PSQI. 8,9,37,38 The present results demonstrate that eGFR as a continuous variable was not a significant determinant for sleep quality in our study cohort (OR: 1.006 per 1 mL/min difference in eGFR, 95% CI: 0.98-1.03, p: 0.63). This finding was supported by a previous report in CKD patients.…”

Section: Discussioncontrasting

confidence: 44%

“…Similarly, evidence indicated that the PSQI global score was not correlated with BMI. 28,37 In contrast, poor sleep quality has been linked to high BMI in the adolescent population without CKD. 40 Strengths of this study include methods related to administration and scoring of the instruments and large sample size with participants from the same centre.…”

Section: Discussionmentioning

confidence: 99%

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Sleep quality and its correlates in patients with chronic kidney disease: a cross-sectional design

et al. 2015

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Purpose: Since sympathovagal imbalance influences clinical phenomena, such as hypertension, diabetes mellitus, chronic kidney disease (CKD) and sleeping problems, there should be correlations between these conditions. We hypothesized that sleep quality would be correlated with estimated glomerular filtration rate (eGFR), blood pressure and the presence of diabetes. Methods: We included 303 CKD patients in this study. We employed the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) and Short Form 36 Quality of Life Health Survey Questions (SF-36) to screen sleeping disturbances, depression and quality of life, respectively. A chart review was performed for the patients' demographics, diagnoses and certain laboratory parameters-including blood glucose, hemoglobin, albumin, calcium, phosphate, parathyroid hormone and eGFR. Multivariate logistic regression models were employed to estimate odds ratios with 95% confidence intervals. Results: We included 303 patients in this cross-sectional study. A total of 101 patients were on dialysis. In the univariate models, gender, calcium and mental component summary scores (MCS) reached a significant level of 0.1, and those covariates were included in the multivariate analysis. The reduced models included gender and MCS categories. Female gender increases the risk for poor sleep quality. In our report, evidence suggests MCS domain scores are inversely related to the risk for impaired sleep. Conclusion: Our results indicated a high burden of sleep disturbances in kidney patients. In addition, female gender and having low MCS scores may influence sleep quality in kidney patients.

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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Sleep quality and its correlates in patients with chronic kidney disease: a cross-sectional design

et al. 2015

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“…Several previous reports using ambulatory blood pressure monitoring indicated that blood pressure and dipping status were associated with impaired sleep. [31][32][33] We only measured blood pressure on one occasion, which might make it difficult to identify any possible correlation between sleep and blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Sleep apnea in patients with chronic kidney disease: a single center experience

et al. 2014

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“…Chronotherapy 50 means timing the administration of antihypertensive drugs in such a way that the blood pressure is lowered over 24 hours, while preserving a normal dipping pattern. Hermida et al 51,52 provided the proof of concept. The classification of patients according to the night-to-day blood pressure ratio heavily depends on arbitrary criteria, is poorly reproducible, 48,[53][54][55] and has a different prognostic meaning according to the outcome under study, 29 the prevailing 24-hour blood pressure level, 29 and treatment status.…”

Section: Why Should Nighttime Blood Pressure Be a Better Predictor?mentioning

confidence: 99%

Predictive Role of the Nighttime Blood Pressure

et al. 2011

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Abstract-Numerous studies addressed the predictive value of the nighttime blood pressure (BP) as captured by ambulatory monitoring. However, arbitrary cutoff limits in dichotomized analyses of continuous variables, data dredging across selected subgroups, extrapolation of cross-sectional studies to prospective outcomes, and lack of comprehensive adjustments for confounders make interpretation of the literature difficult. We reviewed prospective studies with total mortality or a composite cardiovascular end point as an outcome in relation to the level and the circadian profile of systolic BP. We analyzed studies in hypertensive patients (nϭ23 856) separately from those in individuals randomly recruited from populations (nϭ9641). We pooled summary statistics and individual subject data, respectively. In both patients and populations, in analyses in which nighttime BP was additionally adjusted for daytime BP and vice versa, nighttime BP was a stronger predictor than daytime BP. With adjustment for the 24-hour BP, both the night-to-day BP ratio and dipping status remained significant predictors of outcome but added little prognostic value over and beyond the 24-hour BP level. In the absence of conclusive evidence proving that nondipping is a reversible risk factor, the option whether or not to restore the diurnal blood pressure profile to a normal pattern should be left to the clinical judgment of doctors and should be individualized for each patient. Current guidelines on the interpretation of ambulatory BP recording need to be updated. (Hypertension. 2011;57:3-10.) • Online Data Supplement Key Words: ambulatory blood pressure monitoring Ⅲ dipping status Ⅲ nighttime blood pressure Ⅲ night-to-day blood pressure ratio Ⅲ population science Ⅲ risk factors A mbulatory monitoring enables recording the blood pressure throughout the entire day, while subjects engage in their usual day-to-day activities. 1,2 The diurnal blood pressure profile normally includes a 10% to 20% fall in blood pressure during sleep, which is driven by physical inactivity and which is largely independent of an endogenous rhythm. 3 Indeed, in shift workers, the 24-hour blood pressure level and the fall in blood pressure during sleep were similar on days with daytime and nighttime work. 3 In 1988, O'Brien et al 4 reported for the first time that patients with an abnormal circadian blood pressure profile with a less marked decrease in the nighttime blood pressure had a more frequent history of stroke. O'Brien and colleagues thereby coined the terms dipping versus nondipping. Subsequent studies of hypertensive cohorts 5-24 and populations [25][26][27][28][29][30] did not all 8,15,18,26,30 corroborate the worse prognosis associated with a high nighttime blood pressure. Moreover, interpretation of these studies is not always easy. First, positive results based on arbitrary and varying definitions of nondipping were sometimes not supported by analysis of the nocturnal blood pressure fall as a continuous variable. 7,15 Second, in some reports signific...

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Sleep quality among relatively younger patients with initial diagnosis of hypertension: Dippers versus non‐dippers

Cited by 47 publications

References 14 publications

Sleep quality and its correlates in patients with chronic kidney disease: a cross-sectional design

Sleep quality and its correlates in patients with chronic kidney disease: a cross-sectional design

Sleep apnea in patients with chronic kidney disease: a single center experience

Predictive Role of the Nighttime Blood Pressure

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