How Does ABPM Affect Sleep Quality?

While sleep quality is poor among individuals with untreated hypertension, 24-hour ambulatory blood pressure monitoring (ABPM) does not adversely affect sleep quality, according to a new study.

To reach this conclusion, the researchers assessed the sleep quality of 121 participants who were middle aged with untreated hypertension.

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The subjective sleep quality was measured with the Pittsburgh Sleep Quality Index, while the objective sleep quality was measured with a wrist actigraphy. The latter measured sleep efficiency and total sleep time on 7 consecutive non-ABPM days (baseline) and 3 subsequent 24-hour ABPM days.

The average ambulatory blood pressure was 137.2 ± 10.8/84.3 ± 8.5 mm Hg during the day and 119.6 ± 12.4/69.5 ± 9.8 mm Hg at night.

Because there was no effect of time on sleep efficiency or total sleep time on non-ABPM compared with ABPM days, it was determined that ABPM did not adversely affect sleep quality.

The researchers had also identified 40 nondippers (defined as having a dip in systolic BP of less than 10%) and 81 dippers.

Due to having a lower rate of sleep efficiency, nondippers generally had poorer sleep quality than dippers. The fact that a participant might be undergoing a 24-hour ABPM had no effect on this finding.

There was a clear association between participants who were African American having lower sleep efficiency, as well.

“Sleep quality generally appears to be poor in men and women with untreated hypertension and especially among African Americans,” the researchers concluded. “Importantly, for both dippers and nondippers, we found no evidence that ABPM had an adverse effect on sleep quality.”

—Colleen Murphy

Reference:

Sherwood A, Hill LK, Blumenthal JA, Hinderliter AL. The effects of ambulatory blood pressure monitoring on sleep quality in men and women with hypertension: dipper vs. nondipper and race differences. Am J Hypertens. 2019;32(1):54-60. https://doi.org/10.1093/ajh/hpy138.