Effect of antihypertensive medications on sleep status in hypertensive patients

Ziqian Zeng; Yanan Yang; Yuewen Zhang; Xiuming Wu; Weizhong Chen; Dongqing Gu

doi:10.1007/s41105-022-00391-8

Effect of antihypertensive medications on sleep status in hypertensive patients

Sleep Biol Rhythms. 2022 May 18;20(4):473-480. doi: 10.1007/s41105-022-00391-8. eCollection 2022 Oct.

Authors

Ziqian Zeng¹, Yanan Yang², Yuewen Zhang², Xiuming Wu², Weizhong Chen², Dongqing Gu¹

Affiliations

¹ First Affiliated Hospital, Army Medical University, Chongqing, 400038 China.
² Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China.

Abstract

Purpose: Antihypertensive medication is an effective way to control blood pressure. However, some studies reported that it may affect patients' sleep quality during the treatment. Due to the inconsistency of present results, a comprehensive systematic review and network meta-analysis are needed.

Methods: Electronic databases (MEDLINE, EMBASE, WEB OF SCIENCE, PUBMED) were searched up to April 10th, 2021 including no restriction of publication status. Randomized controlled trials (RCTs) or quasi-experimental studies or cohort studies were eligible. The network meta-analysis was used within a Bayesian framework.

Results: Finally, 16 publications (including 12 RCTs and 4 quasi-experimental studies) with 404 subjects were included in this study. Compared to placebo, the results of the network meta-analysis showed that diuretics were effective in improving sleep apnea with a mean difference (MD) of - 15.47 (95% confidence interval [CI]: - 23.56, - 6.59) which was consistent with the direct comparison result (MD: - 17.91; 95% CI - 21.60, - 14.23). In addition, diuretics were effective in increasing nocturnal oxygen saturation with an MD of 3.64 (95% CI 0.07, 7.46). However, the effects of β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and the others on sleep apnea were not statistically significant. Additionally, the effects of antihypertensive medication on the total sleep time (min), rapid eye movement (%), and sleep efficiency (%) were not statistically significant.

Conclusion: Our study found that diuretics could effectively reduce the severity of sleep apnea in hypertensive patients. However, the effects of antihypertensive drugs on sleep characteristics were not found.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-022-00391-8.

Keywords: Antihypertensive medication; Hypertension; Sleep apnea; Sleep characteristics.