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KMID : 0389520180250020051
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Sleep Medicine.Psychophysiology
2018 Volume.25 No. 2 p.51 ~ p.57
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Decreased Nocturnal Blood Pressure Dipping in Patients with Periodic Limb Movements in Sleep
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Lee Mi-Hyun
Choi Jae-Won
Oh Seong-Min
Lee Yu-Jin
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Abstract
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Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for car- diovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep.
Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depres- sion Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bed- time to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI (PLMI ≤ 15) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance.
Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also signi cant when adjusted for gender and age, but were not statistically signi cant when adjusted for BMI, alcohol, 51 smoking, anti-hypertension medication use and sleep ef ciency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a signi cant differ- ence in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smok- ing, antihypertensive medication use and sleep ef ciency (p = 0.023).
Conclusion: PLMS was signi cantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained signi cant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep ef- ciency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.
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KEYWORD
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Periodic limb movements during sleep, Nocturnal blood pressure, Hypertension, Polysomnography
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