Nocturnal Blood Pressure Non-Dipping, Posttraumatic Stress Disorder, and Sleep Quality in Women

Abstract

Women with posttraumatic stress disorder (PTSD) have poor sleep quality and increased risk of cardiovascular disease (CVD). Non-dipping of nocturnal blood pressure may be an explanatory factor for the relationship between sleep and CVD found in previous research. The current study was designed to determine if non-dipping nocturnal blood pressure was associated with trauma exposure, PTSD diagnosis, PTSD symptoms, and sleep quality in a sample of women. Participants completed 24 hours of ABPM and self-report questionnaires. Non-dipping was defined as less than 10% reduction in blood pressure during sleep. The frequency of non-dippers did not differ by diagnostic status (d = .15). However, non-dippers endorsed more traumatic event categories (d = .53), more PTSD hyperarousal symptoms (d = .53), poorer overall sleep quality (d = .59), more frequent use of sleep medication (d = .62), greater sleep-related daytime dysfunction (d = .58), and longer sleep onset latencies (d = .55) than dippers. Increased attention to nocturnal blood pressure variation may be needed to improve blood pressure control in trauma-exposed women.

Keywords:

• cardiovascular disease
• circadian blood pressure
• psychological trauma
• PTSD
• sleep quality

FUNDING

The first author was supported by a Department of Veterans Affairs HSR&D Career Development Award CDA 09-218 while working on this manuscript. Dr. Bosworth is supported by a Research Career Scientist award from the Department of Veterans Affairs Office of Health Services Research and Development (RCS-08-027). Dr. Beckham is supported by a Research Career Scientist award from the Department of Veterans Affairs office of Research and Development Clinical Science. This material is based upon work supported, in part, by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Science and Health Services Research and Development Grants # IIR 00-091 and # IIR 05-213-2. This work was also supported, in part, by the National Institutes of Health Grants R01MH62482 and K24DA016388. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the National Institutes of Health.

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