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J Sleep Med > Volume 17(1); 2020 > Article
J Sleep Med. 2020;17(1):58-65.         doi: https://doi.org/10.13078/jsm.200004
Relationship of Non-Dipper and Reverse-Dipper Pattern with Sleep Quality in Normotensive Patients
Zafer Yalım1 , Sümeyra Alan Yalım2
1Department of Cardiology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
2Department of İnternal Medicine, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
Corresponding Author: Zafer Yalım ,Tel: +90-4440304, Fax: +90-2722463300, Email: zaferyalm@yahoo.com.tr
Received: March 31, 2020   Revised: May 17, 2020   Accepted: June 9, 2020   Published online: June 30, 2020
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Objectives: It has been observed in many different populations that circadian blood pressure (BP) patterns have a significant impact on cardiovascular (CV) results. Important predictors of CV morbidity and mortality are known as non-dipper (ND) and reverse-dipper (RD) BP pattern. RD and ND patterns are frequently encountered in many normotensive patients in daily practice.
Methods: The purpose of this study is to evaluate the frequency and quality of sleep, especially in normotensive young individuals, by using sleep questionnaires and to evaluate their relationship with poor BP patterns. A total of 195 normotensive patients (68 dippers, 63 ND, and 65 RD) were enrolled into this cross-sectional study. The insomnia severity index (ISI), Epworth sleepiness scale (ESS), and Pittsburgh sleep quality index (PSQI) approved questionnaires were applied to evaluate the presence and severity of sleep disorders and to determine the patient’s sleep quality.
Results: When dipper and ND groups were compared, significant differences were observed in ISI, ESS, and PSQI (p<0.001). Then, the study patients were re-evaluated as dipper, ND, and RD groups and seen this significant difference continued (p<0.001). Also, the sleep time was significantly different between all groups of dipper (7.23±0.11 hours), ND (6.72±0.15 hours), and RD (5.79±0.11 hours) (p<0.001). In the correlation analysis, a significant inverse relationship was observed between sleep time and all survey results (p<0.05).
Conclusions: RD and ND patterns are associated with sleep quality in healthy individuals. It is necessary to evaluate patients with RD and ND BP patterns in normotensive individuals in terms of sleep disorders in detail.
Keywords: Blood pressure | Ambulatory blood pressure monitoring | Sleep | Sleep disorders | İnsomnia
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