Effect of nocturnal blood pressure measurement on sleep and blood pressure during sleep

Nocturnal hypertension is of diagnostic interest and has important prognostic and therapeutic implications. Nighttime blood pressure can easily be measured using ambulatory blood pressure monitoring (ABPM). However, during nocturnal ambulatory blood pressure measurement pump noise, tactile stimuli and pressure produced by cuff inflation may alter the quality of sleep and subsequently influence the physiological fall of night time blood pressure. Eight studies were performed to determine whether non-invasive automated blood pressure monitoring during day and/or night provokes alert reaction, arousal, sleep disturbances and changes in blood pressure and/or heart rate. From these studies it can be concluded: 1) Nighttime blood pressure can be evaluated properly using ABPM. 2) Nocturnal blood pressure is not overestimated by ABPM. 3) ABPM does not induce an alarm reaction and a blood pressure rise when monitored with a silently operating recorder. 4) Sleep is often disturbed by blood pressure measurement without provoking a blood pressure increase. 5) In older patients blood pressure measurement and age-related alterations in sleep quality may influence each other.