Sleep disorders are one of the leading complaints of patients with cardiovascular diseases. However, little is reported on interrelations between insomnia, excessive daytime sleepiness as its consequence, metabolic parameters and cardiovascular risks in patients with hypertension. Sleep disorders are one of the risk factors of cardiovascular diseases. At the same time, more than 40% of patients with established diseases of the cardiovascular system have problems with the quality or duration of sleep. The purpose of this study was to find the relationship between antihypertensive therapy and sleep disorders in patients with an isolated course of hypertension and its combination with type 2 diabetes mellitus. Material and methods. A cross-sectional study was conducted. The study included 38 patients with an isolated hypertension, 82 patients with its combination with type 2 diabetes and 23 healthy volunteers. Exclusion criteria included the history of myocardial infarction or stroke, cardiac insufficiency or ejection fraction below 45%, resistant arterial hypertension, abnormal thyroid function, onsets of peptic or duodenal ulcer diseases, co-morbidities that affect the quality of life, obesity stage 3, any active oncological diseases, insomnia as a symptom of any psychic disorder, treatment with glucocorticosteroids, moxonidine, reserpine, β-blockers, hypnotic drugs, nocturnal food intake, and obstructive sleep apnea. Body mass index (kg/m2) was assessed. Insomnia was diagnosed in accordance with the International Classification of Sleep Disorders – Third Edition (ICSD-3). To detect obstructive sleep apnea, a portable monitoring device SOMNOcheck micro CARDIO (2013, Germany) was used. Statistical analysis was performed using SPSS 17.0 software. Data are presented as the mean (M) and standard deviation (SD) in case of normal distribution and as the median and interquartile range (25% and 75%) if the distribution is not normal. Numerical values are shown as the number (n) and percentage (%). To compare independent groups of variables, either Student’s test or Mann-Whitney test was used. When comparing more than two groups, ANOVA test was selected. Results and discussion. The study showed that insomnia prevailed in the group of patients with hypertension (p=0.05), whereas in the combined course of hypertension and type 2 diabetes mellitus, circadian rhythm sleep-wake disorders (p=0.028), as well as obstructive sleep apnea. Antihypertensive therapy in the groups was comparable in composition and dose. It was revealed that among patients with an isolated course of hypertension receiving amlodipine (p=0.05) and valsartan (p=0.04), insomnia was significantly less diagnosed. When calculating the odds ratio, weobserved that the risk of early awakenings and the difficulty of maintaining sleep was significantly lower in the group of patients treated with amlodipine (p=0.005). Conclusion. The patients with an isolated course of hypertension and with its combination with type 2 diabetes mellitus had significantly more frequent sleep disorders than the control group patients. Amlodipine was associated with a lower incidence of insomnia symptoms.
Keywords: insomnia, amlodipine, early awakenings, difficulty of maintaining sleep
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