Orthostatic hypotension and subjective sleep quality in older people

Abstract

Poor sleep quality and orthostatic hypotension are common complaints in an older population, and both are related to factors such as polypharmacy and depression. However, it is not known whether there is a direct association between the two. Our objective is to investigate a potential association between orthostatic blood pressure response and subjective sleep quality in older people. A within-subjects, cross-sectional design embedded in a larger longitudinal study design. Participants were recruited from the community to visit the TRIL clinic at St James's Hospital, where they underwent a structured medical and psychosocial assessment. A total of 505 community dwelling adults aged 60+ (321 females, mean age 72.44) were participated in this study. Orthostatic blood pressure responses were recorded during an active stand using Finometer equipment, and health-related factors such as pain ratings, co-morbidities, polypharmacy, timed up and go, Mini-Mental State Examination score, body mass index, as well as depression, anxiety, age and gender, were also recorded. Self-reported sleep quality was also assessed using the Pittsburgh Sleep Quality Index. The results showed that timed up and go, polypharmacy, depression, anxiety, gender and delayed recovery of blood pressure at orthostasis were associated with subjective poor sleep quality. There is an association between subjective sleep quality and delayed recovery of blood pressure at orthostasis, independent of mental health or polypharmacy effects, in older adults. This link may have implications for the management of sleep disorders in older people.

Keywords:

• depression
• sleep problems
• physical health status

Acknowledgements

The authors would like to acknowledge Dr Cathal Walsh of the Department of Statistics, Trinity College Dublin, for his statistical advice, Dr Roman Romero-Ortuno, St James's Hospital, Clodagh Cunningham for her role in recruitment, the research team involved in data collection, and the individuals who participated in TRIL research.

Funding

This study was funded as part of a wider programme of research within the TRIL Centre, (Technology Research for Independent Living). The TRIL Centre is a multi-disciplinary research centre, bringing together researchers from UCD, TCD, NUIG and Intel, funded by Intel, IDA Ireland and GE Healthcare. www.trilcentre.org