Correlation Between Sleep Quality And Blood Pressure Rhythm In Patients With Essential Hypertension

Background:As a result of modern city nightlife,night shift work,jet lag,sleep rhythm disorder phenomenon is greatly increased,sleep rhythm disorders can be through the change of autonomic nervous system excitability and through a series of neurohumoral way lead to blood pressure circadian rhythm disorders.Normal blood pressure rhythm is "scoop"form,means night-time blood pressure lower 10 to 20%than which in the daytime.If night-time blood pressure does not drop(non-dipper blood pressure rhythm)or night-time blood pressure higher than that in day-time(anti-dipper blood pressure rhythm)called blood pressure circadian rhythm disorders.Ancient Chinese time-diving method divide one day to twelve ShiChens which are ZiShi,ChouShi,ChenShi,SiShi,WuShi,WeiShi,ShenShi,YouShi,XuShi,HaiShi.Traditional Chinese time medicine believe that the qi and blood of human run a cycle in the meridians circulation all the twelve ShiChens to nourish the body.In order to maintain the normal physiological function of the human body,people should comply with the Circadian rhythm,activity in the daytime and sleep at night.Because the main operation of the organs and meridians is time-varying,in different time human viscera function is also different.Go to bed at the wrong time may lead to abnormal sleep quality and cause blood pressure circadian rhythm disorders.Objective:1.To determine the difference of sleep quality and blood pressure rhythm in patients with essential hypertension under different sleeping hours.2.To observe the 12 hours parasympathetic nerve intensity changes of patients with essential hypertension who sleep in different hours.Discussed different hour of sleep affect the mechanism of circadian rhythm of blood pressure patients with essential hypertension from the perspective of parasympathetic nerve.Methods:188 patients with essential hypertension were collected according to the inclusion criteria,and the cases were from the international department of china-japan friendship hospital and the department of cardiology.After general demographic information collection,use the cardiopulmonary coupling measurement based on the analysis of ShiChen and 24 hours ambulatory blood pressure monitoring to get volunteers' sleep quality and 24 hours ambulatory blood pressure and related data,according to volunteers,time of get into sleep,divided the patients in HaiShi group(sleep time is after HaiShi before ZiShi,namely at 21:00?23:00,referred to as HaiShi group),sleep time in ZiShi group(sleep time is after ZiShi before ChouShi,namely at 23:00?1:00,referred to as ZiShi group),sleep time in ChouShi group(sleep time is after ChouShi before YinShi,namely at 1:00?3:00,referred to as ChouShi group),The difference in sleep quality and circadian rhythm of blood pressure between the two groups was compared.And then to sleep time length in 6 to 7 h subgroup analysis was conducted among 111 subjects,also divide into HaiShi groups,ZiShi group,ChouShi group according to their sleep hours.Contrast analysis the sleep quality,blood pressure circadian rhythm and intensity of parasympathetic nerve among the groups.Research results:Sleep quality Contrast analysis among the groups showed:(1)entering the sleeping time,sleeping time:HaiShi group>ZiShi group>ChouShi group(P<0.05),shallow sleep time and wake/dreaming time:HaiShi group<ZiShi group<ChouShi group(P<0.05).(2)Incidence of blood pressure circadian rhythm disorder(non-dipper and anti-dipper blood pressure rhythm)in sleeping time in 6-7 hours subgroups indicating that:(1)The time it takes from wakefulness to deep sleep:HaiShi group>ZiShi group>ChouShi group(P<0.05).Deep sleeping time:ZiShi group>ChouShi group>HaiShi group(P<0.05).Light sleep time or waking/dreaming time:HaiShi group>ChouShi group>ZiShi group(P<0.05).(2)Proportion of non-dipper blood pressure rhytlun:HaiShi group<ZiShi group<ChouShi group(P<0.05).Proportion of anti-dipper blood pressure rhythm:HaiShi group<ZiShi group<ChouShi group(P<0.05).(3)the intensity of parasympathetic nerve in the three groups increased at night and decreased at day.The nocturnal increase of parasympathetic nerve intensity in HaiShi group was lower than that in the ZiShi group and the ChouShi group,and the difference was statistically significant(P<0.05).Conclusions:(1)With the delay of sleep time and early awakening,the deep sleep time of subjects will be shortened,the time of light sleep and the time of waking/dreaming will be increased,and the sleep stability will be decreased.Parasympathetic nerve strength decreased,the incidence of blood pressure rhythm disorder increased.(2)The length of sleep and the ShiChen of sleep are both important sleep factors that influence the circadian rhythm of blood pressure.Any abnormality in either of them will have an abnormal effect on the circadian rhythm of blood pressure.