Association between sleep disturbance and nocturnal blood pressure profiles by a linear mixed model analysis: the Nagahama study
Association between sleep disturbance and nocturnal blood pressure profiles by a linear mixed model analysis: the Nagahama study
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DOI：
10.1016/j.sleep.2019.01.049
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发表时间：
2019-09-01
期刊：
影响因子：
4.8
通讯作者：
Chin, Kazuo
中科院分区：
文献类型：
--
作者：
Matsumoto, Takeshi;Tabara, Yasuharu;Chin, Kazuo
目的：我们旨在分析睡眠障碍，包括睡眠呼吸紊乱、睡眠碎片和睡眠效率，与夜间血压异常的关系，这些可能是心血管不良结局的危险因素。方法：研究包括5854名社区居民，进行20725次多天测量。使用戴在手腕上的活动监测器评估睡眠碎片和效率。睡眠呼吸障碍的评估使用3%的氧减饱和指数，根据活动图确定的睡眠时间进行校正。结果：夜间平均收缩压变化为-8.6+/-9.7%(-11.1+/-12.6 mm Hg)，夜间血压变化的日间相关系数为0.443。使用每日测量值的线性混合模型分析结果发现，睡眠效率较低(系数=-0.130，p<；0.001)是夜间SBP下降的决定因素，超过了这些参数的日间变化。夜间排尿次数是另一个强有力的决定因素(系数=1.191，p<；0.001)，尽管睡眠效率与夜间排尿、醒着的收缩压和睡眠呼吸紊乱无关(系数=-0.102，p<；0.001)。睡眠效率也与睡眠收缩压水平独立相关(系数=-0.138，p<；0.001)。夜间SBP下降和睡眠SBP水平与睡眠效率(<80%)之间的差异估计分别为1.63%(1.09-2.17%)和2.16 mm Hg(1.49-2.82%)。结论：睡眠效率是维持血压昼夜节律的一个因素，应引起高度重视。(C)2019爱思唯尔B.V.保留所有权利。
Objectives: We aimed to analyze associations of sleep disturbance, including sleep disordered breathing, sleep fragmentation, and sleep efficiency, with abnormal nocturnal blood pressure (BP) profiles that may be risk factors for adverse cardiovascular outcomes.Methods: The study included 5854 community residents with 20,725 multi-day measurements. Sleep fragmentation and efficiency were evaluated using a wrist-worn activity monitor. Sleep disordered breathing was assessed using the 3% oxygen desaturation index corrected for actigraphy-determined sleep duration. A timer-equipped standard cuff-oscillometric device was used for home and sleep BP monitoring.Results: Mean nocturnal systolic BP (SBP) change was -8.6 +/- 9.7% (-11.1 +/- 12.6 mmHg), and inter-day correlation coefficient of the nocturnal SBP change was 0.443. Results of a linear mixed model analysis using daily measured values identified lower sleep efficiency (coefficient = -0.130, p < 0.001) as a determinant for decreased nocturnal SBP dipping beyond the interday variations of these parameters. Number of nocturnal urinations was another strong determinant (coefficient = 1.191, p < 0.001), although the association of sleep efficiency was independent of nocturnal urination, awake SBP, and sleep disordered breathing (coefficient = -0.102, p < 0.001). Sleep efficiency was also independently associated with sleep SBP level (coefficient = -0.138, p < 0.001). Estimated differences in nocturnal SBP dipping and sleep SBP level as a function of the degree of sleep efficiency (less than 80%) reached 1.63% (1.09-2.17%) and 2.16 mmHg (1.49-2.82%), respectively.Conclusion: More attention should be paid to sleep efficiency as a factor in maintaining circadian BP rhythm. (C) 2019 Elsevier B.V. All rights reserved.