Poor-quality sleep score is an independent predictor of nondipping hypertension

We aimed to investigate whether there was any association between the nondipping status and sleep quality in relatively young patients with an initial diagnosis of hypertension.

One hundred and thirty-three consecutive patients, diagnosed to have stage 1 hypertension by their primary physicians, were referred to our study. Patients with a history of use of any antihypertensive medication were excluded. Eligible patients underwent the Pittsburgh Sleep Quality Index (PSQI) survey, which has an established role in evaluating sleep disturbances. All patients underwent ambulatory blood pressure monitoring.

There were 71 nondipper patients (mean age 44.3+/-5.3 years, 33 male/38 female) and 62 dipper hypertensive patients (mean age 43.3+/-6.3 years, 27 male/35 female). The PSQI scores, globally, were significantly higher in the nondippers compared with the dippers. It was noticed that all the components of the PSQI (sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction) were significantly higher in the nondippers. Correlation analysis showed that systolic blood pressure fall at night was inversely and significantly related with the PSQI (r=-0.46, P<0.001). Logistic regression analysis showed that the PSQI score is an independent determinant for nondipping hypertension (HT) {odds ratio=0.842 [95% confidence interval (CI)=0.748-0.947; P=0.004]}.

We showed that poor sleep quality was related with a nondipping pattern, and furthermore, it was an independent predictor of nondipping in newly diagnosed stage 1 hypertensive patients.