Treatment of sleep disorders in patients with hypertension and obesity
DOI:
https://doi.org/10.14739/2310-1210.2019.6.186481Keywords:
sleep disorders, hypertension, obesity, daily monitoring of blood pressure, therapyAbstract
T
The aim of the study is to improve the efficacy of the treatment of sleep disorders in patients with arterial hypertension (AH) and obesity.
Materials and methods. In total, 62 patients were examined (mean age 58.3 ± 2.3 years) with AH and obesity. All of the surveyed persons underwent general clinical examination, daily BP monitoring, life quality assessment (General Well-Being Questionnaire). The ICSD-2 (2005) criteria were used to identify sleep disorders (dyssomnia) and subjective sleep characteristics questionnaires – for circadian “sleep –wake” rhythm disturbances assessment. Sleep disorders were found in all the examined patients at baseline. After the baseline data registration, the patients were prescribed basic therapy, 32 (group 1) of whom additionally received melatonin at a dose of 3 mg for 4 weeks; 30 patients were included in group 2.
Results. After treatment, in group 1, the levels of office SBP and DBP were 6.9 % and 6.7 % (P < 0.05), and the average daily SBP and DBP (according to DMBP data) were 7.9 % and 6.7 % (P < 0.05) lower, respectively, than in group2. In patients of group 1, positive changes in lipid and carbohydrate metabolism, a significant improvement in subjective sleep characteristics and circadian “sleep – wake” rhythm were registered along with an improvement in the quality of life.
Conclusions. Thus, melatonin add-on treatment in patients with AH and obesity with sleep disorders increases the efficacy of antihypertensive therapy, has a beneficial effect on glucometabolic parameters, subjective assessment of sleep quality and the quality of life.
References
Kovalenko, V. M. (2013). Rehionalni medyko-sotsialni problemy khvorob systemy krovoobihu [Regional medico-social problems of circulatory system diseases]. Kyiv. [in Ukrainian].
Netiazhenko, V. Z., & Puzanova, O. H. (2009). Arterialna hipertenziia yak faktor kardiovaskuliarnoho ryzyku [Hypertension as a cardiovascular risk factor]. Internal medicine, 1-2(13-14), 9-26. [in Ukrainian].
Nedogoda, S. V., Barykina, I. N., Salasjuk, A. S., Hripaeva, V. Yu., & Smirnova, V. O. (2015). Ispolzovanie kompleksnoj terapii v vedenii metabolicheskogo sindroma [The use of multi-component therapy in the management of metabolic syndrome]. Almanac of Clinical Medicine, 1, 51-59. [in Russian].
Pinhasov, B. B., Seljatickaja, V. G., Karapetjan, A. R., Galanova, Zh. M., & Dobrovolskaja, N. P. (2012). Vozrastnaja zavisimost associacii metabolicheskogo sindroma s tipami ozhirenija u zhenshhin [Age dependence of metabolic syndrome association with obesity species among women]. Advances in Gerontology, 25(4), 617-622. [in Russian].
Cappuccio, F., Taggart, F., Kandala, N., Currie, A., Peile, E., Stranges, S., & Miller, M. (2008). Meta-analysis of short sleep duration and obesity in children and adults. Sleep, 31(5), 619-626. doi: 10.1093/sleep/31.5.619
Olejnikov, V. Je., Sergackaja, N. V., & Tomashevskaja, Ju. A. (2012). Vzaimosvjaz ozhirenija i narushenij uglevodnogo obmena s sindromom obstruktivnogo apnoje vo sne [Association of obesity and carbohydrate metabolism disorders and sleep apnea syndrome]. International medical journal, 18(3), 31-39. [in Russian].
Faraut, B., Touchette, É., Gamble, H., Royant-Parola, S., Safar, M., Varsat, B., & Léger, D. (2012). Short sleep duration and increased risk of hypertension: a primary care medicine investigation. Journal Of Hypertension, 30(7), 1354-1363. doi: 10.1097/HJH.0b013e32835465e5
Mesri Alamdari, N., Mahdavi, R., Roshanravan, N., Lotfi Yaghin, N., Ostadrahimi, A., & Faramarzi, E. (2015). A double-blind, placebo-controlled trial related to the effects of melatonin on oxidative stress and inflammatory parameters of obese wome. Hormone And Metabolic Research, 47(7), 504-508. doi: 10.1055/s-0034-1384587
AASM. (2005). International classification of sleep disorders: Diagnostic and coding manual. Westchester, IL: American Academy of Sleep Medicine.
World Health Organization (WHO) (2003). Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=ACF94113894A623DEAC113A146C394D0?sequence=1
Rogoza, A. N., Agalcov, M. V., & Sergeeva, M. V. (2005). Sutochnoe monitorirovanie arterialnogo davlenija: varianty vrachebnyh zakljuchenij i kommentarii [24-hour ambulatory blood pressure monitoring: medical opinions and comments]. Nizhny Novgorod. [in Russian].
Levin, Ja. I. (1995). Farmakoterapija insomnij: rol imovana [Pharmacotherapy for insomnia: the role of imovan]. Levin, Ja. I., Eligulashvili, T. S., Posohov, S. I., Kovrov, G. V., & Bashmakov, M. Ju. Sleep disorders. St. Petersburg: MNA, pp. 56-61. [in Russian].
Crnko, S., Du Pré, B., Sluijter, J., & Van Laake, L. (2019). Circadian rhythms and the molecular clock in cardiovascular biology and disease. Nature Reviews Cardiology, 16(7), 437-447. doi: 10.1038/s41569-019-0167-4
Jahno, N. N., Zaharov, V. V. (2002). Kognitivnye i jemocionalno-affektivnye narushenija pri discirkuljatornoj jencefalopatii [Cognitive and emotional-affective disorders in discirculatory encephalopathy]. Russian Medical Journal, 12, 539-542. [in Russian].
Agabiti-Rosei, C., De Ciuceis, C., Rossini, C., Porteri, E., Rodella, L., & Withers, S. et al. (2014). Anticontractile activity of perivascular fat in obese mice and the effect of long-term treatment with melatonin. Journal Of Hypertension, 32(6), 1264-1274. doi: 10.1097/hjh.0000000000000178
Bonnefont-Rousselot, D. (2014). Obesity and Oxidative Stress: Potential Roles of Melatonin as Antioxidant and Metabolic Regulator. Endocrine‚ Metabolic & Immune Disorders-Drug Targets, 14(3), 159-168. doi: 10.2174/1871530314666140604151452
Robeva, R., Kirilov, G., Tomova, A., & Kumanov, P. (2008). Melatonin-insulin interactions in patients with metabolic syndrome. Journal Of Pineal Research, 44(1), 52-56. doi: 10.1111/j.1600-079x.2007.00527
Cagnacci, A., Arangino, S., Renzi, A., Paoletti, A., Melis, G., Cagnacci, P., & Volpe, A. (2001). Influence of melatonin administration on glucose tolerance and insulin sensitivity of postmenopausal women. Clinical Endocrinology, 54(3), 339-346. doi: 10.1046/j.1365-2265.2001.01232.x
Mühlbauer, E., Gross, E., Labucay, K., Wolgast, S., & Peschke, E. (2009). Loss of melatonin signalling and its impact on circadian rhythms in mouse organs regulating blood glucose. European Journal Of Pharmacology, 606(1-3), 61-71. doi: 10.1016/j.ejphar.2009.01.029
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