Effect of Nocturia and Sleep Quality on Sleep Blood Pressure: The HI-JAMP Study.

BACKGROUND

Blood pressure (BP) during sleep is known to be affected by sleep disturbance, including nocturia and sleep disorders. This study investigated the effect of nocturia and self-reported poor sleep on BP using a multisensor BP monitoring device (TM-2441; A&D Co) equipped with an accelerator.

METHODS

This analysis is part of the HI-JAMP study (Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective), in which 24-hour ambulatory BP monitoring with simultaneously monitored physical activity using a multisensor all-in-one device was performed in hypertensive patients taking at least 1 antihypertensive agent. Sleep time, awake time, nocturia frequency, and sleep assessment on the ambulatory BP monitoring night were collected from a self-report diary. Nighttime BP was defined as the BP measured between self-reported sleep and awakening times. Sleep BP was defined as the BP without physical activity during a sleep period.

RESULTS

Data of 1252 individuals (mean age, 67.4±11.7 years; mean body mass index, 24.8±3.9 kg/m2; 58.2% male) were analyzed. Averages of sleep systolic BP (SBP) were lower than those of nighttime SBP (113.9±15.8 versus 115.2±15.5 mm Hg; P<0.001). Frequency of nocturnal voids was associated with an increase in nighttime systolic SBP (1-2×: 4.7 mm Hg, P<0.001; ≥3×: 9.6 mm Hg, P<0.001) and sleep SBP (1-2×: 4.1 mm Hg, P<0.001; ≥3×: 8.5 mm Hg, P<0.001). Self-reported poor sleep showed a marginal association with increased nighttime SBP but was not associated with sleep SBP.

CONCLUSIONS

Compared with self-reported poor sleep, nocturia had a greater impact on BP during sleep, even after excluding BP readings with nocturnal physical activity.

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