Marital conflict and nocturnal blood pressure dipping in military couples

Our goal was to examine the association between marital conflict and nocturnal blood pressure dipping (NBP) in Iraq/Afghanistan healthy veterans and their partners and to determine whether sleep disturbances mediate such associations.

The sample consisted of 25 heterosexual couples comprised of male veterans and their female civilian spouses/partners. Blood pressure was measured across 48 hr, and NBP was calculated as the ratio of sleep/wake mean arterial pressure (MAP). Marital conflict was assessed by questionnaire. Sleep was assessed via in-home polysomnography (PSG). Posttraumatic stress disorder (PTSD) diagnosis was determined via clinician interview and was included as a covariate in all analyses, along with body mass index, age, gender, and deployment characteristics.

Higher marital conflict was associated with higher MAP ratios (β = .74, p < .01), with the effect stronger among women (β = -0.68, p < .05, for gender interaction). Among women only, for each SD increase in marital conflict there was a .82 increase in MAP ratio (p < .01). This association was reduced to nonsignificance after adjustment for PSG-assessed sleep efficiency.

Consistent with limited prior work in civilian samples, higher marital conflict in military couples was associated with blunted NBP, particularly among women. These findings highlight the importance of considering the health and well-being of both veterans and their partners in the aftermath of war, as well as the importance of considering nighttime physiological pathways that are relevant to cardiovascular disease risk. (PsycINFO Database Record