Impact of 24-h blood pressure monitoring on objective sleep duration and fragmentation in resistant hypertensive patients

Objectives: 24-h ambulatory blood pressure monitoring (ABPM) is crucial for diagnosis of treatment-resistant hypertension (RH). However, repetitive cuff inflations during nighttime might induce sleep deprivation and hamper physiological nocturnal BP fall. The study was aimed at investigating the impact of the ABPM on sleep duration and fragmentation in RH. Methods: 20 RH patients and 18 healthy controls (HC) were recruited and underwent 7-day actigraphy and ABPM. Total sleep time (TSTtot and TSTABPM), wake after sleep onset (WASOtot and WASOABPM) and sleep efficiency (SEtot and SEABPM) were calculated on the whole week and separately for the ABPM night. Results: RH patients were older (62 11 vs 28 4 years, P < 0.001), had higher 24-h (133 17/76 15 vs 122 10/ 75 5 mmHg, P = 0.02 and P = 0.66) and nighttime BP (120 18/71 15 vs 107 11/63 7 mmHg, P < 0.001 and P = 0.05) and a reduced dipping (6 6 vs 17 5%, P < 0.001) than HC. RH had a lower TSTtot than HC (6.4 1.1 vs 7.6 1.1 h, P < 0.01). TSTABPM was not reduced during the ABPM night in both groups (6.8 1.3 and 7.6 1.3, P=ns vs TSTtot for both). However, WASOABPM tended to be longer than WASOtot in RH (RH: 73 34 vs 61 29 min, P = 0.07; HC 31 23 vs 33 22 min, P=ns; P for interaction group-time 0.10), and SEABPM was slightly reduced in RH (84.4 7.2 vs 86.2 7.2%, P = 0.09) but not in HC (93.6 4.7 vs 93.1 4.8% P = 0.74). None of the considered sleep parameters correlated with 24 h-BP. Conclusions: ABPM did not significantly influence objective sleep duration and only marginally induce sleep fragmentation, thus can be safely used for diagnosis of resistant hypertension. Disclosure: Nothing to disclose