Sleep Quality Disturbances and Blood Pressure Values

When high blood pressure (TK) values are high, doctors ask their patients the question: “Are you sleeping well?” What is the relationship between hypertension and sleep disorders? Is high blood pressure one of the causes of sleep disorders or are sleep disturbances causing the onset of TK the next day, possibly even for a longer period of time? Now we do not consider acute, temporary sleep disorders under the influence of current stress states that clearly increase the “drive” of sympathy. We will also not deal with


Results
In Table 1 the basic characteristics of the set at time M0, including the values of systolic and diastolic blood pressure, heart rate and point values of the questionnaire at the beginning of the study [2]. It is evident that the mean values of systolic and diastolic blood pressure were slightly increased and mean BMI values were at the beginning of obesity. The average score values of the questionnaire were in the "suspected insomnia" band.
Three months of added rilmenidine treatment, the quality of sleep improved, and the mean value of the questionnaire score was in the "no sleep disorder" band ( Figure 1). At the same time, the mean values of both systolic and diastolic blood pressure, which have reached the controlled hypertensive band, decreased markedly, statistically significant. The mean heart rate decreased by 6 strokes / min, similarly to our previous studies with rilmenidine ( Figure 2). By correlation analysis between the sleep quality questionnaire scores and the blood pressure values we found some dependence on blood systolic blood pressure at the beginning of the study (slightly above the statistical significance limit), more significant dependence was found for both systolic and diastolic TK at the end of the study (Figure 3 & 4). Statistically significant correlations of blood systolic blood pressure differences were also statistically significant, and the difference between the point score at the start and end of the study (delta sTK versus the delta score) ( Table 3).     During insomnia, sleep disorders of NREM I, NREM IV (delta), sleep architecture are impaired, individual stages are changed [7]. Insomnia is more susceptible to individuals with certain predispositions and psychophysiological manifestations, e.g. with an increased response to grief, reduced calming capacity, with a tendency to rumination. Short sleep and sleep disturbances are a risk factor for hypertension, and good sleep is associated with a decrease in TK values [8]. In so-called. CARDIA sleep study in 578 adults repeatedly tested over 3 years with 3-meter acclimetry for 3 consecutive nights showed that reducing sleep duration by 1 hour was associated with an increased risk of hypertension by 37%.
Javaheri et al. [9] investigated 238 adolescents in the sleeping lab and the actimetry, Who simultaneously measured TK for two days 9 times. With a shorter sleep duration of 6.5 hours, the risk of "prehypertension" increased 2.8-fold and when sleep-efficiency was <85% 4.5-fold.
After adjusting for the presence of other potentially effective factors, these values were 2.5 resp. 3.5 [9]. In the sub-group with sleep disorders, the systolic TK values were on average 4 mmHg higher than in the subgroup without these disorders. The short duration of sleep is associated with a rise in nighttime sleep up significantly increases cardiovascular mortality in older people. In a study of three French cities, Empana et al. [11], daily sleepiness was questioned by a structured interview on a sample of 9300 people great Greek study, the prosperity of the afternoon sleep with short sleep, siesta [12], proved to be beneficial. In observance of the siosy, even after adjusting for possible distortive factors, the mortality rate for ischemic heart disease was reduced by 37%.
Certain sleep times and adequate quality are important conditions for the proper functioning of the immune system and glucose metabolism. Short sleep duration is associated with an increased risk of obesity and diabetes, which is explained by a hormone-induced increased appetite and appetite for sweet meals and reduced energy expenditure throughout the day. At a minimum, 7 hours of sleep is generally considered. Some say they feel well after a short sleep, but testing has shown that their performance is not optimal [8]. The hyperactivity of the sympathetic nervous system is considered to be the main mechanism for increasing TK in chronic insomnia. Night "micro" wake increases sympathetic activity and thus increases TK. Another possible mechanism is an aging-induced decrease in melatonin level, which not only synchronizes the circadian rhythm of sleep and wakefulness but reduces TK at nighttime by its vasodilating action. High TK values at night, Non-dipping hypertension in patients with sleep disorders is 3 times more common than those who sleep well [13]. This type of hypertension is associated with high cardiovascular risk and nightly TK values are the strongest prognostic factor [14].

Conclusion
It should be emphasized that physicians should also take into account the quality and duration of sleep in the care of patients with essential hypertension and in assessing cardiovascular risk.
In selecting treatment, consideration should also be given to the possibility of positively influencing the quality of sleep and nighttime TK values, not just a decrease in TK during the day. In the prevention of hypertension, it is necessary to put emphasis not only on optimal weight, regular exercise, but also on quality and long enough sleep.