Sleep's quality disorders in patients with hypertension and type 2 diabetes mellitus

Fiorentini, Alessandra; Valente, Rosita; Perciaccante, Antonio; Tubani, Luigi

doi:10.1016/j.ijcard.2006.07.213

Cited by 70 publications

(45 citation statements)

References 6 publications

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“…The reports indicated that diabetes was more common in those with high PSQI global scores (14.9% vs. 8.8%, p50.001). 38 We have demonstrated that BMI and IWG have not been associated with poor sleep quality in our study cohort. Similarly, evidence indicated that the PSQI global score was not correlated with BMI.…”

Section: Discussionsupporting

confidence: 42%

“…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: Discussionmentioning

confidence: 43%

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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: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 43%

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

et al. 2015

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“…They found that poor sleep quality, defi ned by a Pittsburgh Sleep Quality Index score > 5, was more frequent among those with hyperte nsion. 14 Knutson et al. examined the association between sleep quality, measured by actigraphy, and blood pressure in mid-life adults.…”

mentioning

confidence: 99%

Sleep and Pregnancy-Induced Hypertension: A Possible Target for Intervention?

Haney

Buysse²,

Okun³

2013

Journal of Clinical Sleep Medicine

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Sleep disturbances in the general population are associated with elevated blood pressure. This may be due to several mechanisms, including sympathetic activation and hypothalamic-pituitary-adrenal (HPA) axis disturbance. Elevated blood pressure in pregnancy can have devastating effects on both maternal and fetal health and is associated with increased risk for preeclampsia and poor delivery outcomes. Preliminary evidence suggests that mechanisms linking sleep and blood pressure in the general population may also hold in the pregnant population. However, the effects of disturbed sleep on physiologic mechanisms that may directly infl uence blood pressure in pregnancy have not been well studied. The role that sleep disturbance plays in gestational blood pressure elevation and its subsequent consequences warrant further investigation. This review evaluates the current literature on sleep disturbance and elevated blood pressure in pregnancy and proposes possible treatment interventions. T he association between sleep disturbances and elevated blood pressure has been extensively studied in the general population. However, relatively few studies have investigated this relationship in the pregnant population. Pregnancy predisposes women to a variety of sleep disturbances.1,2 Similar to non-pregnant individuals, sleep disturbance in pregnancy may be a risk factor for elevated blood pressure, which can lead to maternal and fetal morbidity . 3,4Gestational hypertension, defi ned as a blood pressure higher than 140/90 diagnosed after 20 weeks of gestation, is associated with fetal growth restriction and abruptio placentae and can predispose to preeclampsia, as well as cardiovascular disease later in lif e. 1,[4][5][6] There are few studies evaluating the link between sleep and blood pressure during pregnancy. In this paper, we fi rst review the relationship between sleep and blood pressure in non-pregnant adults. We then outline factors that predispose pregnant women to poor sleep. We conclude with a review of the emerging literature on the associations between sleep and blood pressure in pregnancy. SLEEP AND BLOOD PRESSURE IN THE NON-PREGNANT POPULATIONIn the U.S. the average sleep duration has decreased by 1.5-2 h/night, with > 30% of Americans sleeping < 6 h/night. 7This phenomenon and the concurrent increase in hypertension intimated a possible link between sleep duration and blood pressure. Recently, a series of epidemiological papers have noted an association between sleep duration (both short and long) and elevated blood press ure [8][9][10][11] ; for example, the Sleep Heart Health Study reported that participants who slept < 5 or ≥ 9 h/night had a greater frequency of hypertension than individuals sleeping

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“…It has been reported that the prevalence of hypertension in subjects who are 'poor sleepers' is 87.1% compared with 35.1% in 'good sleepers' . 24 The increasing interest in the association between sleep disorders and significant comorbidities, including hypertension and glucose metabolism disorders, suggests that studies screening for cardiovascular risk should include an evaluation of sleep quality with questionnaires such as the PSQI. In this regard, our results indicate that the reduction in blood pressure caused by combined losartan /HCTZ treatment may lead to improvements in cardiovascular mortality and morbidity, partially as a consequence of improved sleep quality.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive treatment using an angiotensin receptor blocker and a thiazide diuretic improves patients’ quality of life: The Saga Challenge Antihypertensive Study (S-CATS)

Kamura

Inoue

Kuroki³

et al. 2011

Hypertens Res

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The aim of the Saga Challenge Antihypertensive Study (S-CATS), a single-arm, prospective and multi-center trial, was to evaluate the effectiveness of combined antihypertensive treatment with losartan and hydrochlorothiazide (HCTZ). Enrolled in the study were a total of 161 patients with hypertension, who in spite of treatment with an angiotensin receptor blocker (ARB) alone or an ARB and calcium channel blocker (CCB), had not been able to reach blood pressure control goals set by the Japanese Society of Hypertension Guidelines (JSH 2004). The ARBs were replaced with a combination pill containing losartan (50 mg) and HCTZ (12.5 mg), and this treatment was continued for 3 months. This change in therapy resulted in significant decreases in systolic (158 ± 14 to 137 ± 15 mm Hg, Po0.001) and diastolic (85 ± 11 to 76 ± 10 mm Hg, Po0.001) blood pressure and heart rate (73±3 to 72±3) during the study. The patients' quality of life (QOL) score, the EuroQol 5 dimensions (EQ-5D) and the visual analog scale (VAS) (n¼96; 70.0 (68.8-80.0) to 80.0 (70.0-90.0), Po0.01) all improved significantly. Another QOL score, the hypertension symptom score (HSS), which we originally developed for the S-CATS trial, decreased significantly (n¼93; 4.0 (1.0-9.0) to 2.0 (1.0-8.0), Po0.05). The Pittsburgh sleep quality index (PSQI), which is a psychometric assessment of subjective sleep quality, also decreased significantly (n¼45; 4.0 (2.0-7.0) to 3.0 (2.0-5.0), Po0.05). There was a significant correlation between a change in HSS (baseline value À3-months value) and a decrease in systolic blood pressure (n¼93; R¼0.241, Po0.05). These results suggest that an anti-hypertensive treatment combined with an ARB and a thiazide diuretic may improve patients' QOL, including sleep quality.

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Sleep's quality disorders in patients with hypertension and type 2 diabetes mellitus

Cited by 70 publications

References 6 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 and Pregnancy-Induced Hypertension: A Possible Target for Intervention?

Antihypertensive treatment using an angiotensin receptor blocker and a thiazide diuretic improves patients’ quality of life: The Saga Challenge Antihypertensive Study (S-CATS)

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