Effects of insomnia and restless legs syndrome on sleep arterial blood pressure: A systematic review and meta-analysis

Maiolino, Giuseppe; Bisogni, Valeria; Soranna, Davide; Pengo, Martino F.; Pucci, Giacomo; Vettor, Roberto; Fava, Cristiano; Colussi, Gian Luca; Bilo, Grzegorz; Lombardi, Carolina; Parati, Gianfranco; Rossi, Gian Paolo; Silvani, Alessandro

doi:10.1016/j.smrv.2021.101497

Cited by 28 publications

(10 citation statements)

References 63 publications

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“…ABPM enables the collection of crucial data on blood pressure changes associated with sleep. Moreover, there is currently a lack of data regarding the presence of other significant sleep disorders, such as insomnia and restless legs syndrome, which may have the potential to impact nighttime sleep-related blood pressure values ( 52 ). We acknowledge the importance of investigating the potential effects of these disorders on NREM sleep stages and their potential relationship to hypertension.…”

Section: Discussionmentioning

confidence: 99%

Objective sleep characteristics and hypertension: a community-based cohort study

Chen,

Zhang,

Huang

2024

Front. Cardiovasc. Med.

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ObjectiveThe link between sleep quality and hypertension risk is well-established. However, research on the specific dose-relationship between objective sleep characteristics and hypertension incidence remains limited. This study aims to explore the dose-relationship association between objective sleep characteristics and hypertension incidence.MethodsA community-based prospective cohort study design was employed using data from the Sleep Heart Health Study (SHHS). A total of 2,460 individuals were included in the study, of which 780 had hypertension. Baseline personal characteristics and medical history were collected. Objective sleep characteristics were obtained through polysomnography (PSG). Multivariate logistic regression models were utilized for analysis. Restricted cubic splines (RCS) were used to examine dose-relationship associations.ResultsAfter adjusting for covariates, the percentage of total sleep duration in stage 2 (N2%) was positively associated with hypertension incidence, while the N3% was negatively associated with hypertension incidence Odds ratio (OR) = 1.009, 95% confidence interval (CI) [1.001, 1.018], P = 0.037; OR = 0.987, 95% CI: [0.979, 0.995], P = 0.028, respectively. For every 10% increase in N2 sleep, the risk of developing hypertension increases by 9%, while a 3% decrease in N3 sleep corresponds to a 0.1% increase in the incidence of hypertension. In the subgroup of non-depression, a positive association between N2% and hypertension was significant statistically (OR = 1.012, 95%CI, 1.002, 1.021, P = 0.013, Pinteraction = 0.013). RCS demonstrated that the risk of developing hypertension was lower when N2% ranged from 38% to 58% and rapidly increased thereafter (P = 0.002, non-linear P = 0.040). The lowest risk for hypertension incidence risk of N3% occurring at 25%, and a significant increase below 15% or above 40% (P = 0.001, non-linear P = 0.008).ConclusionsThere's a negative association between N3% and the incidence of hypertension, and a positive association between N2% and the incidence of hypertension, particularly among non-depression individuals. These associations exhibit strong non-linear dose-response relationships.

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Section: Discussionmentioning

confidence: 99%

Objective sleep characteristics and hypertension: a community-based cohort study

Chen,

Zhang,

Huang

2024

Front. Cardiovasc. Med.

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“…Although the pathological mechanism of sleep disturbance after hypertension was complex. However, it can develop as a result of hypertension due to factors such as persistent physiological stress [ 28 ], increased sympathetic nervous system activity causing alertness [ 29 , 30 ], disrupted nighttime blood pressure patterns [ 31 ], potential sleep-affecting medication side effects [ 32 ], psychological impact from hypertension management [ 33 ], and endothelial dysfunction [ 34 , 35 ], all of which contribute to sleep disruptions. Effective hypertension treatment, lifestyle changes [ 36 ], and stress reduction measures are critical for sleep disturbance [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

The mediating effect of sleep disturbance on the association between hypertension and depression: a national data analysis

Latief,

Akyirem,

Sithichoksakulchai

et al. 2024

Clin Hypertens

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Background Sleep disturbance is a common among people with hypertension. However, the mediating role of sleep disturbance in the association between hypertension and depression remains unclear. This study aims to investigate the mediating role of sleep disturbance in the association between hypertension and depression. Materials and methods This was cross-sectional study. The data were derived from the Indonesian Family Life Survey Fifth Wave (2014–2015). We include a total of 19,138 adults’ participants with age range from 18 to 65 years old who completed response on the variable of hypertension, sleep disturbance, and depression. The mediating model analysis was processed using the PROCESS macro ins SPSS from Hayes model. Results Depression was reported by 22% of total respondents. The group with hypertension showed a substantially higher prevalence of depression than non-hypertension group (P < 0.001). Hypertension had a significant overall effect on depression (β = 0.682; 95%CI 0.489 to 0.875, P < 0.001). The direct effect of hypertension on depression was significant (β = 0.418; 95%CI 0.244 to 0.592, P < 0.001) and the indirect effect that mediated by sleep disturbance was also significant (β = 0.264, 95%CI 0.174 to 0.356, P < 0.001). It is worth noting that sleep disturbance partially mediated the association between hypertension and depression. Conclusion The findings of this study indicated that sleep disturbance contributed to the etiology of depression and hypertension in adult populations. Nurses should be involved in managing sleep disturbances, such as using behavioral therapy, as it may serve as both a treatment and primary prevention measure for depression and hypertension. Graphical Abstract

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“…But studies have shown that blood pressure indicators associated with increased risk of cardiovascular disease are nighttime, 24 h, daytime, home self-assessment, and office blood pressure in order of correlation ( 50 ). And there is currently evidence to support ( 51 ) insomnia as a risk factor for nocturnal hypertension and abnormal blood pressure rhythms. Therefore, it is necessary to pay attention to the blood pressure during sleep in patients with hypertension and insomnia.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for hypertension with insomnia: Study protocol for a randomized, sham-controlled, subject-and-assessor-blinded trial

Wang

Liu

et al. 2022

Front. Psychiatry

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BackgroundPrevious studies show that insomnia and hypertension are closely related. Currently, intervention for hypertension with insomnia has become a research hotspot. Acupuncture, as a representative non-pharmaceutical therapy of traditional Chinese medicine (TCM), has been widely used in improving insomnia and hypertension. However, there are few clinical studies on acupuncture for hypertension with insomnia.MethodsA single-center, subject-and-assessor-blind, randomized, sham-controlled trial has been designed for a study to be conducted in Jiangsu Province Hospital of Chinese Medicine. Sixty eligible patients will be randomly assigned to the treatment group and the control group in a 1:1 ratio. The treatment group will receive acupuncture treatment, while the control group will receive sham acupuncture treatment. Both groups will be treated three times per week for 4 weeks. Data will be collected at baseline and after 4 weeks of treatment and analyzed by using SPSS 25.0. The primary outcome measures are sleep parameters of portable polysomnography before and after treatment. Secondary outcomes are Pittsburgh Sleep Quality Index, Insomnia Severity Index, home blood pressure, and heart rate variability.DiscussionThis study aims to evaluate the efficacy of acupuncture using the portable polysomnography combined with sleep scales, and analyze heart rate variability to preliminarily explore the underlying mechanism of acupuncture on hypertension with insomnia. The trail, if proven to be effective, will provide strong scientific evidence to support acupuncture is effective to manage patients for hypertension with insomnia.Clinical trial registrationChiCTR2200059161.

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Effects of insomnia and restless legs syndrome on sleep arterial blood pressure: A systematic review and meta-analysis

Cited by 28 publications

References 63 publications

Objective sleep characteristics and hypertension: a community-based cohort study

Objective sleep characteristics and hypertension: a community-based cohort study

The mediating effect of sleep disturbance on the association between hypertension and depression: a national data analysis

Acupuncture for hypertension with insomnia: Study protocol for a randomized, sham-controlled, subject-and-assessor-blinded trial

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