AIM To explore the relationship between sleep disorders and blood pressure variability (BPV) in individuals with hypertension, providing a theoretical basis for personalized hypertension management strategies.

METHODS A total of 300 patients with hypertension in the First Medical Center, the Sixth Medical Center of the PLA General Hospital and other cooperative hospitals from January 2023 to April 2024 were recruited as the study subjects. The general clinical information of the participants was gathered, with all participants undergoing 24-hour ambulatory blood pressure monitoring as well as sleep quality assessment. Based on their Pittsburgh Sleep Quality Index (PSQI) score, the participants were categorized into two groups: a simple hypertension group (n=134) and a hypertension with sleep disorder group (n=166). Differences in baseline characteristics, 24-hour blood pressure readings, and BPV were compared between the two groups. Additionally, multiple linear regression analysis was conducted to examine the association between sleep disorders and BPV in hypertensive patients, with BPV quantified using the standard deviation (SD) and coefficient of variation (CV) of blood pressure.

RESULTS Compared with the simple hypertension group, patients with hypertension combined with sleep disorders had a higher age (P<0.05), a higher proportion of coronary heart disease (P<0.05), a higher proportion of somatic symptom disorders (P<0.05), a higher proportion of oral antihypertensive drug use (P<0.05), and a lower total cholesterol (TC) (P<0.01). The 24-hour mean systolic blood pressure (24 h SBP), daytime mean systolic blood pressure (dSBP), nighttime mean systolic blood pressure (nSBP), 24-hour mean diastolic blood pressure (24 h DBP), daytime mean diastolic blood pressure (dDBP), and nighttime mean diastolic blood pressure (nDBP) of patients with hypertension combined with sleep disorders were significantly higher than those of the simple hypertension group (all P<0.01). In terms of BPV, the 24 h SBP-SD, dSBP-SD, nSBP-SD, 24 h DBP-SD, dDBP-SD, nDBP-SD, 24 h SBP-CV, and dSBP-CV in the hypertension combined with sleep disorders group were significantly higher than those in the simple hypertension group (all P<0.01). In addition, nSBP CV was higher than that of the simple hypertension group (P<0.05). After adjusting for confounding factors such as age, coronary heart disease, history of somatic symptoms, oral antihypertensive medication, and total cholesterol, sleep disorders were independently associated with 24 h SBP-SD (P<0.01), dSBP-SD (P<0.01), 24 h DBP-SD (P<0.05), dDBP-SD (P<0.01), 24 h SBP-CV (P<0.05), and dSBP-CV (P<0.01) (B=2.491, B=2.858, B=1.286, B=1.701, B=1.012, B=1.370).

CONCLUSION Sleep disorders represent an independent risk factor for elevated BPV in hypertensive patients.