Repetitive exposure to shortened sleep leads to blunted sleep-associated blood pressure dipping.
Repetitive exposure to shortened sleep leads to blunted sleep-associated blood pressure dipping.
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DOI：
10.1097/hjh.0000000000001284
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发表时间：
2017-06
影响因子：
4.9
通讯作者：
Mullington JM
中科院分区：
文献类型：
--
作者：
Yang H;Haack M;Gautam S;Meier-Ewert HK;Mullington JM
血压（BP）在健康个体的夜间睡眠期间下降，但在睡眠不佳的情况下，下降是迟钝的。然而，慢性睡眠时间不足，有限的间歇性恢复睡眠，对血压下降的影响尚不清楚。本研究的目的是在一个对照实验模型中，研究长期睡眠限制对夜间和白天血压模式的影响。在一项高度受控的22天住院方案中，45名健康参与者（年龄32±2岁; BMI 24±1 kg/m2; 22名男性和23名女性）被随机分配到以下两种情况之一：1）重复睡眠限制;（从0300-0700持续3个晚上，每晚睡眠4小时，随后恢复睡眠8小时，连续重复4次），或2）睡眠对照组（从2300-0700每晚8小时）。记录心跳间血压和多导睡眠图，发现在所有4个睡眠限制区组中，睡眠相关舒张压（DBP）下降显著减弱（p=0.002）。此外，在第1、2和4个睡眠限制块期间，DBP全天显著升高（所有p<0.01），在第1个睡眠限制块期间，收缩压（SBP）全天显著升高。总之，反复暴露于显著缩短的睡眠会减弱睡眠相关的血压下降，尽管间歇性的追赶睡眠。由于睡眠相关血压下降的反复钝化以及由此导致的平均昼夜血压升高，经常睡眠不足的个体可能会增加患高血压的风险。
Blood pressure (BP) dips at night during sleep in healthy individuals but in disturbed sleep, dipping is blunted. However, the impact of chronic insufficient sleep duration, with limited intermittent recovery sleep, on BP dipping is not known. The objective of this study was to examine, in a controlled experimental model, the influence of chronic sleep restriction on BP patterns at night and during the day. In a highly controlled 22-day in-hospital protocol, 45 healthy participants (age 32±2 yrs.; BMI 24±1 kg/m2; 22 men and 23 women) were randomly assigned to one of two conditions: 1) repeated sleep restriction; (4h of sleep/night from 0300–0700 for 3 nights followed by recovery sleep of 8h, repeated 4 times in succession), or 2) a sleep control group (8h/night from 2300-0700). Beat-to-beat BP and polysomnography were recorded and revealed that sleep-associated diastolic blood pressure (DBP) dipping was significantly blunted during all 4 blocks of sleep restriction (p=0.002). Further, DBP was significantly increased for the whole day during the 1st, 2nd and 4th block of sleep restriction (all p<0.01), and systolic blood pressure (SBP) was significantly increased for the whole day during the 1st block of sleep restriction. In conclusion, repeated exposure to significantly shortened sleep blunts sleep-associated BP dipping, despite intermittent catch-up sleep. Individuals frequently experiencing insufficient sleep may be at increased risk for hypertension due to repetitive blunting of sleep-associated BP dipping, and resultant elevations in average circadian BP.