Hypertension and insomnia


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Abstract

Insomnia is frequently detected in patients with arterial hypertension (AH): from 19% to 47.9% of all cases according to epidemiological studies. On the other hand, the frequency of hypertension in patients with insomnia ranges from 21.4% to 50.2%, whereas in patients without insomnia, from 11.0% to 41.8%. In single studies in which patients with insomnia underwent ambulatory blood pressure monitoring (ABPM), these patients showed higher nocturnal blood pressure levels. Recent data suggests that insomnia is also a risk factor for hypertension. Among the pathogenetic mechanisms explaining the relationship between hypertension and insomnia, an increase in the activity of the main neuroendocrine stress systems, sympatho - adrenal and hypothalamic - pituitary - adrenal, and the frequent presence of concomitant anxiety disorders are discussed. To determine the sleep quality in patients with insomnia, the Pittsburgh Sleep Quality Index (PSQI) is most often used, patients with hypertension in a number of studies had higher total PSQI score compared to individuals with normal blood pressure. PSQI score correlates with systolic and diastolic blood pressure level, as well as with the presence of non - dipper blood pressure profile. Both hypertension and insomnia are associated with impaired cognitive functions. However, the relationship between cognitive impairment and insomnia is rather contradictory, which is most associated with the methodology for assessing cognitive functions and differences in the initial clinical and demographic characteristics of the examined patient population.

About the authors

T M Ostroumova

Sechenov First Moscow State Medical University (Sechenov University)

к.м.н., асcистент каф. нервных болезней и нейрохирургии лечебного фак-та ФГБОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России (Сеченовский Университет), ORCID: 0000-0003-1499-247x Moscow, Russia

V A Parfenov

Sechenov First Moscow State Medical University (Sechenov University)

д.м.н., проф., зав. каф. нервных болезней и нейрохирургии лечебного фак-та ФГБОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России (Сеченовский Университет), ORCID: 0000-0002-1992-7960 Moscow, Russia

O D Ostroumova

Sechenov First Moscow State Medical University (Sechenov University); Pirogov Russian National Research Medical University - Russian Clinical and Research Center of Gerontology

Email: ostroumova.olga@mail.ru
д.м.н., проф. каф. клинической фармакологии и пропедевтики внутренних болезней ФГБОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России (Сеченовский Университет); зав. лаб. клинической фармакологии и фармакотерапии ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России - ОСП «Российский геронтологический научно-клинический центр»; ORCID: 0000-0002-0795-8225 Moscow, Russia

A I Kochetkov

Pirogov Russian National Research Medical University - Russian Clinical and Research Center of Gerontology

к.м.н., н.с. лаб. клинической фармакологии и фармакотерапии ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России - ОСП «Российский геронтологический научно-клинический центр», ассистент каф. болезней старения ФДПО ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, ORCID: 0000-0001-5801-3742 Moscow, Russia

References

  1. Полуэктов М.Г., Бузунов Р.В., Авербух В.М., Вербицкий Е.В., Захаров А.В., Кельмансон И.А. и др. Проект клинических рекомендаций по диагностике и лечению хронической инсомнии у взрослых. Consilium Medicum. Неврология и Ревматология. 2016;2(прил.):41-51.
  2. Lichstein K.L, Taylor D.J, Mc Crae C.S, Petrov M.E. Insomnia: epidemiology and risk factors. In: Kryger M.H, Roth T, Dement W.C, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia: Elsevier, 2016:761-768.
  3. Голенков А.В., Полуэктов М.Г. Распространенность нарушений сна у жителей Чувашии (данные сплошного анкетного опроса). Журнал неврологии и психиатрии им. С.С. Корсакова. 2011;111(6):64-7.
  4. Бочкарев М.В., Коростовцева Л.С., Фильченко И.А., Ротарь О.П., Свиряев Ю.В., Жернакова Ю.В. и др. Социально - демографические аспекты инсомнии в российской популяции по данным исследования ЭССЕ-РФ. Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски. 2018;118(4):26-34. doi: 10.17116/jnevro2018 1184226
  5. Zhang B, Wing Y.K. Sex differences in insomnia: a meta - analysis. Sleep. 2006;29(1):85-93. doi: 10.1093/sleep/29.1.85
  6. O’Brien E, Sheridan J, O’Malley K. Dippers and non - dippers. Lancet. 1988;332(8607):397. doi: 10.1016/s0140-6736(88)92867-x
  7. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Hypertens J. 2013;31:1281-357. doi: 10.1093/eurheartj/eht151
  8. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183-9. doi: 10.1097/00004872-20021100 0-00017
  9. Kario K, Pickering T.G, Matsuo T, Hoshide S, Schwartz J.E, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertens. 2001;38(4):852-7. doi: 10.1161/hy1001.092 640
  10. Cuspidi C, Michev I, Meani S, Severgnini B, Fusi V, Corti C, et al. Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension. J Human Hypertens. 2003;17(4):245-51. doi: 10.1038/sj.jhh.1001546
  11. Fagard R.H, Celis H, Thijs L, Staessen J.A, Clement D.L, De Buyzere M.L, De Bacquer D.A. Daytime and nighttime blood pressure as predictors of death and cause - specific cardiovascular events in hypertension. Hypertens. 2008;51(1):55-61. doi: 10.1161/hypertensionaha.107.100727
  12. Dolan E, Stanton A.V, Thom S, Caulfield M, Atkins N, Mc Innes G, et al. Ambulatory blood pressure monitoring predicts cardiovascular events in treated hypertensive patients - an Anglo-Scandinavian cardiac outcomes trial substudy. J Hypertens. 2009;27(4):876-85. doi: 10.1097/hjh.0b013e32 8322cd62
  13. Sen P, Mukhopadhyay A.K, Chatterjee P, Biswas T. Association of Sleep Disorders with Essential Hypertension in Subcontinental Population. Indian Medical Gazette, 2012:463-466.
  14. Karnik R, Peethambaran K, Adsule S. A cross - sectional, multicentric, epidemiology study to determine the prevalence of insomnia and related sleep habits in Indian hypertensive patients. Int J Research in Medical Sciences. 2017;5(3):787. doi: 10.18203/2320-6012.ijrms20170508
  15. Piwonski J, Piotrowski W, Prejbisz A. Prevalence of insomnia in the Warsaw metropolitan area (Pol-Monica Bis) - Relationship to hypertension and other cardiovascular risk factors. J Hypertens. 2003;21(1):S171.
  16. Prejbisz A, Kabat M, Januszewicz A, Szelenberger W, Piotrowska A.J, Piotrowski W, et al. Characterization of insomnia in patients with essential hypertension. Blood Pressure. 2006;15(4):213-9. doi: 10.1080/08 037050600963040
  17. Миронов С.П., Щепин О.П., Романов А.И., Максимова Т.М. Концептуальная и экспериментальная проработка эпидемиологии нарушений сна у населения России. Кремлевская медицина. Клинический вестник. 1998;5:17-23.
  18. Taylor D.J, Mallory L.J, Lichstein K.L, Durrence H.H, Riedel B.W, Bush A.J. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30(2):213-8. doi: 10.1093/sleep/30.2.21319. Wang Y.M, Song M, Wang R, Shi L, He J, Fan T.T, et al. Insomnia and multimorbidity in the community elderly in China. J Clinical Sleep Medicine. 2017;13(4):591-7. doi: 10.5664/jcsm.6550
  19. Benbir G, Demir A.U, Aksu M, Ardic S, Firat H, Itil O, et al. Prevalence of insomnia and its clinical correlates in a general population in Turkey. Psychiatry and Clinical Neurosciences. 2015;69(9):543-52. doi: 10.1111/ pcn.12252
  20. Sasaki N, Fujiwara S, Ozono R, Yamashita H, Kihara Y. Lower blood pressure and smaller pulse pressure in sleeping pill users. A large - scale cross - sectional analysis. Medicine. 2017;96(42):e8272. doi: 10.1097/md. 0000000000008272
  21. Lanfranchi P.A, Pennestri M.H, Fradette L, Dumont M, Morin C.M, Montplaisir J. Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk. Sleep. 2009;32(6):760-6. doi: 10.1093/sleep/32.6.760
  22. Goncharuk V.D, Van Heerikhuize J, Swaab D.F, Buijs R.M. Paraventricular nucleus of the human hypothalamus in primary hypertension: activation of corticotropin - releasing hormone neurons. J Comparative Neurology. 2002; 443(4):321-31. doi: 10.1002/cne.10124
  23. Stow L.R, Richards J, Cheng K.Y, Lynch I.J, Jeffers L.A, Greenlee M.M, et al. The circadian protein period 1 contributes to blood pressure control and coordinately regulates renal sodium transport genes. Hypertens. 2012;59(6):1151-6. doi: 10.1161/hypertensionaha.112.190892
  24. Doi M, Takahashi Y, Komatsu R, Yamazaki F, Yamada H, Haraguchi S, et al. Salt - sensitive hypertension in circadian clock - deficient cry - null mice involves dysregulated adrenal Hsd3b6. Nature Medicine. 2010;16(1):67-74. doi: 10.1038/nm.2061
  25. Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Medicine Reviews. 2008;12(3):197-210. doi: 10.1016/ j.smrv.2007.07.007
  26. Mc Ewen B.S. Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load. Metabolism. 2006;55(suppl 2):S20-S23. doi: 10.1016/j.metabol.2006.07.008
  27. Zhong X, Hilton H.J, Gates G.J, Jelic S, Stern Y, Bartels M.N, et al. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Applied Physiol. 2005;98(6):2024-32. doi: 10.1152/japplphysiol.00620.2004
  28. Sayk F, Teckentrup C, Becker C, Heutling D, Wellhöner P, Lehnert H, Dodt C. Effects of selective slow - wave sleep deprivation on nocturnal blood pressure dipping and daytime blood pressure regulation. Am J Physiology-Regulatory, Integrative and Comparative Physiology. 2010;298(1):R191-R197. doi: 10.1152/ajpregu.00368.2009
  29. Ogedegbe G, Pickering T.G, Clemow L, Chaplin W, Spruill T.M, Albanese G.M, et al. The misdiagnosis of hypertension: the role of patient anxiety. Archives of Internal Medicine. 2008;168(22):2459-65. doi: 10.1001/arc hinte.168.22.2459
  30. Kayano H, Koba S, Matsui T, Fukuoka H, Toshida T, Sakai T, et al. Anxiety disorder is associated with nocturnal and early morning hypertension with or without morning surge: ambulatory blood pressure monitoring. Circulation J. 2012;76(7):1670-7. doi: 10.1253/circj.cj-11-1085
  31. Ford D.E, Kamerow D.B. Epidemiologic study of sleep disturbances and psychiatric disorders. JAMA. 1989;262(11):1479. doi: 10.1001/jama.1989.03430110069030
  32. Юдина Н.В., Ишутина Н.П., Раева Т.В. Психические расстройства на начальных стадиях эссенциальной артериальной гипертензии. Медицинская наука и образование Урала. 2009;(1):70-3.
  33. Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C. The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews. 2010;14(1):19-31. doi: 10.1016/j. smrv.2009.04.002
  34. De Zambotti M, Covassin N, De Min Tona G, Sarlo M, Stegagno L. Sleep onset and cardiovascular activity in primary insomnia. J Sleep Research. 2011;20(2):318-25. doi: 10.1111/j.1365-2869.2010.00871.x
  35. Irwin M.R, Wang M, Ribeiro D, Cho H.J, Olmstead R, Breen E.C, et al. Sleep loss activates cellular inflammatory signaling. Biological Psychiatry. 2008;64(6):538-40. doi: 10.1016/j.biopsych.2008.05.004
  36. Mullington J.M, Haack M, Toth M, Serrador J.M, Meier-Ewert H.K. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Progress in Cardiovascular Diseases. 2009;51(4):294-302. doi: 10.1016/j.pcad.2008.10.003
  37. Phillips B, Bůzková P, Enright P. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep. 2009;32(1):65-72. doi: 10.5665/sleep/32.1.65
  38. Fernandez-Mendoza J, Vgontzas A.N, Liao D, Shaffer M.L, Vela-Bueno A, Basta M, Bixler E.O. Insomnia with Objective Short Sleep Duration and Incident Hypertension. The Penn State Cohort. Hypertens. 2012;60(4):929-35. doi: 10.1161/hypertensionaha.112.193268
  39. Wang Q, Xi B, Liu M, Zhang Y, Fu M. Short sleep duration is associated with hypertension risk among adults: a systematic review and meta - analysis. Hypertens Research. 2012;35(10):1012-8. doi: 10.1038/hr.2012.91
  40. Meng L, Zheng Y, Hui R. The relationship of sleep duration and insomnia to risk of hypertension incidence: a meta - analysis of prospective cohort studies. Hypertens Research. 2013;36(11):985-95. doi: 10.1038/ hr.2013.70
  41. Buysse D.J, Reynolds C.F, Monk T.H, Berman S.R, Kupfer D.J. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989;28(2):193-213. doi: 10.1016/0165-1781(89)90 047-4
  42. Liu R.Q, Qian Z, Trevathan E, Chang J.J, Zelicoff A, Hao Y.T, et al. Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: results from a large population - based study. Hypertens Research. 2016;39(1):54-9. doi: 10.1038/hr.2015.98
  43. Lu K, Ding R.J, Tang Q, Chen J, Wang L, Wang C, et al. Association between self - reported global sleep status and prevalence of hypertension in Chinese adults: data from the Kailuan community. Int J Environmental Research and Public Health. 2015;12(1):488-503. doi: 10.3390/ijerph120100488
  44. Bruno R.M, Palagini L, Gemignani A, Virdis A, Di Giulio A, Ghiadoni L, et al. Poor sleep quality and resistant hypertension. Sleep Medicine. 2013;14(11):1157-63. doi: 10.1016/j.sleep.2013.04.020
  45. Kaya Z, Kayrak M, Demir K, Gündüz M, Alibasiç H, Karanfil M, et al. The relationship between white coat hypertension and sleep quality. Sleep and Biological Rhythms. 2014;12(3):203-11. doi: 10.1111/sbr.12070
  46. Парфенов В.А., Остроумова Т.М., Остроумова О.Д., Павлеева Е.Е. Особенности клинической картины у пациентов среднего возраста с эссенциальной артериальной гипертензией. Терапевтический архив. 2018;90(9):15-26. doi: 10.26442/terarkh201890915-26
  47. Erden I, Erden E.C, Ozhan H, Basar C, Aydin M, Dumlu T, Alemdar R. Poor - quality sleep score is an independent predictor of nondipping hypertension. Blood Pressure Monitoring. 2010;15(4):184-7. doi: 10.1097/ mbp.0b013e32833a23a0
  48. Huang Y, Mai W, Hu Y, Wu Y, Song Y, Qiu R, et al. Poor sleep quality, stress status, and sympathetic nervous system activation in nondipping hypertension. Blood Pressure Monitoring. 2011;16(6):117-23. doi: 10.1097/mbp.0b013e32834c672d
  49. Ulu S.M, Ulu S, Ulasli S.S, Yaman G, Ahsen A, Ozkececi G, Yuksel S. Is impaired sleep quality responsible for a nondipping pattern even in normotensive individuals? Blood Pressure Monitoring. 2013;18(4):183-7. doi: 10.1097/mbp.0b013e3283624b03
  50. Li Y, Yang Y, Li Q, Yang X, Wang Y, Ku W.L, Li H. The impact of the improvement of insomnia on blood pressure in hypertensive patients. J Sleep Research. 2017;26(1):105-14. doi: 10.1111/jsr.12411
  51. Grossman E, Laudon M, Zisapel N. Effect of melatonin on nocturnal blood pressure: meta - analysis of randomized controlled trials Effect of melatonin on nocturnal blood pressure: meta - analysis of randomized controlled trials. Vascular Health and Risk Management. 2011;7:577-84. doi: 10.2147/vhrm.s24603
  52. Oxenkrug G.F, Summergrad P. Ramelteon attenuates age - associated hypertension and weight gain in spontaneously hypertensive rats. Ann NY Academy of Sciences. 2010;1199(1):114-20. doi: 10.1111/j.1749-6632.2009.05355.x
  53. Li A, Hindmarch C.C, Nattie E.E, Paton J.F. Antagonism of orexin receptors significantly lowers blood pressure in spontaneously hypertensive rats. J Physiol. 2013;591(17):4237-48. doi: 10.1113/jphysiol.2013.256271
  54. Kitajima T, Kanbayashi T, Saito Y, Takahashi Y, Ogawa Y, Sugiyama T, et al. Diazepam reduces both arterial blood pressure and muscle sympathetic nerve activity in human. Neuroscience Letters. 2004;355(1-2):77-80. doi: 10.1016/j.neulet.2003.10.054
  55. Marty J, Gauzit R, Lefevre P, Couderc E, Farinotti R, Henzel C, Desmonts J.M. Effects of diazepam and midazolam on baroreflex control of heart rate and on sympathetic activity in humans. Anesthesia & Analgesia. 1986;65(2):113-9.
  56. Tulen J.H, Man in't Veld A.J. Noninvasive indices of autonomic regulation after alprazolam and lorazepam: effects on sympathovagal balance. J Cardiovascular Pharmacol. 1998;32(2):183-90. doi: 10.1097/00005344-199808000-00003
  57. Huang Y, Mai W, Cai X, Hu Y, Song Y, Qiu R, et al. The effect of zolpidem on sleep quality, stress status, and nondipping hypertension. Sleep Medicine. 2012;13(3):263-8. doi: 10.1016/j.sleep.2011.07.016
  58. Мартынов А.И., Вейн А.М., Остроумова О.Д., Елигулашвили Т.С., Мамаев В.И., Новинский А.А. Применение зопиклона для коррекции повышенного артериального давления в цикле сон - бодрствование у пожилых больных с эссенциальной гипертензией и инсомнией. Кардиология. 2002:8:11-4.
  59. Fernandez-Mendoza J, Calhoun S, Bixler E.O, Pejovic S, Karataraki M, Liao D, et al. Insomnia with objective short sleep duration is associated with deficits in neuropsychological performance: a general population study. Sleep. 2010;33(4):459-65. doi: 10.1093/sleep/33.4.459
  60. Kyle S.D, Sexton C.E, Feige B, Luik A.I, Lane J, Saxena R, et al. Sleep and cognitive performance: Cross - sectional associations from the UK Biobank. Sleep Medicine. 2017;38:85-91. doi: 10.1016/ j.sleep.2017.07.001
  61. Goldman-Mellor S, Caspi A, Gregory A.M, Harrington H, Poulton R, Moffitt T.E. Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population - based study. Sleep. 2015;38(4):623-31. doi: 10.5665/sleep.4584
  62. Nebes R.D, Buysse D.J, Halligan E.M, Houck P.R, Monk T.H. Self - reported sleep quality predicts poor cognitive performance in healthy older adults. J Gerontology Series B: Psychological Sciences and Social Sciences. 2009;64B(2):180-7. doi: 10.1093/geronb/gbn037
  63. Ling A, Lim M.L, Gwee X, Ho R.C, Collinson S.L, Ng T.P. Insomnia and daytime neuropsychological test performance in older adults. Sleep Medicine. 2016;17:7-12. doi: 10.1016/j.sleep.2015.07.037
  64. Fortier-Brochu E, Beaulieu-Bonneau S, Ivers H, Morin C.M. Insomnia and daytime cognitive performance: a meta - analysis. Sleep Medicine Reviews. 2012;16(1):83-94. doi: 10.1016/j.smrv.2011.03.008
  65. de Almondes K.M, Costa M.V, Malloy-Diniz L.F, Diniz B.S. Insomnia and risk of dementia in older adults: systematic review and meta - analysis. J Psychiatric Research. 2016;77:109-15. doi: 10.1016/j.jpsychires.2016.02. 021

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