'Patients losing sleep over BP monitors'

Rajiv Agarwal, MD (Indiana University and Veterans Affairs Medical Center, Indianapolis) and Robert Light, BS (also of Indiana University) assessed the results of 24-hour blood pressure monitoring in 103 patients with kidney disease.

Ambulatory blood pressure monitoring test records variations in blood pressure from daytime to nighttime.

Blood pressure normally "dips" at night-when it doesn't, the cardiovascular risks of high blood pressure are much greater. As part of a research study, the patients' activity levels were measured using a wristwatch-like device called an actiwatch.

Agarwal explained: "Blood pressure (BP), measured during sleep correlates better with heart attacks and strokes compared to blood pressure measured in the doctor's office.

"However, if blood pressure measurement disturbs sleep, then it may weaken the relationship between 'sleeping BP' and these cardiovascular events."

He added: "We were measuring activity, sleep and ambulatory BP for diagnosing masked hypertension and found this interesting observation."

The lack of the normal nighttime 'dip' in blood pressure was related to increased activity levels, because the blood pressure monitor was disturbing the patients' sleep.

On nights when patients were using the blood pressure monitor, they spent an average of 90 minutes less time in bed. They also spent less time asleep and slept less efficiently.

Patients who awoke at night during blood pressure monitoring were ten times less as likely to have the normal nighttime 'dip.'

Agarwal concluded: "Nighttime blood pressure is lower not because of the time of the day, but because people are asleep. The ambulatory monitoring technique can disturb sleep, and therefore raise the nighttime blood pressure as an artifact.

"Thus sleep quality should be taken into account when interpreting blood pressure during sleep."

The study has been published in an upcoming issue of Clinical Journal of the American Society of Nephrology (CJASN). (ANI)

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