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Kusko DA, Blake J, Williams R. A Narrative Review of the Effects of Mindfulness on Sleep and Hypertension. Curr Hypertens Rep 2024; 26:91-97. [PMID: 37921937 DOI: 10.1007/s11906-023-01279-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE OF REVIEW The prevalence of both insomnia and hypertension in the general population is vast and the health implications to individuals and society are costly. The current pharmacological treatment options for insomnia and hypertension are limited and patients are becoming increasingly interested in non-pharmacological treatment options. Mindfulness, a disciplined mental training practice rooted in Eastern traditions, has become a widely popular treatment method for multiple chronic health problems. The aim of this paper was to review research on mindfulness-based intervention effects on sleep, insomnia, and hypertension from the past 3 years. Theoretical foundations of mindfulness are discussed. Empirical evidence and potential mechanisms of how mindfulness impacts sleep and hypertension are provided. RECENT FINDINGS Our findings suggest that mindfulness-based interventions are safe and effective for people with insomnia and hypertension. We saw consistent, albeit small to moderate, effects of mindfulness-based interventions on reducing insomnia symptoms, improving sleep quality, and lowering systolic and diastolic blood pressure readings. While mindfulness interventions have shown to be effective for improving sleep and lowering hypertension, future research is needed to further evaluate their efficacy on larger samples of patient populations with long-term follow-up measures. These high-quality studies could help researchers and clinicians identify treatment response tendencies in patient populations which can lead to better tailoring of mindfulness-based interventions for specific health concerns.
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Affiliation(s)
- Daniel A Kusko
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd Room 237G, Birmingham, AL, 35233, USA.
| | - Jason Blake
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd Room 237G, Birmingham, AL, 35233, USA
| | - Rebecca Williams
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd Room 237G, Birmingham, AL, 35233, USA
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Kanki M, Nath AP, Xiang R, Yiallourou S, Fuller PJ, Cole TJ, Cánovas R, Young MJ. Poor sleep and shift work associate with increased blood pressure and inflammation in UK Biobank participants. Nat Commun 2023; 14:7096. [PMID: 37925459 PMCID: PMC10625529 DOI: 10.1038/s41467-023-42758-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
Disrupted circadian rhythms have been linked to an increased risk of hypertension and cardiovascular disease. However, many studies show inconsistent findings and are not sufficiently powered for targeted subgroup analyses. Using the UK Biobank cohort, we evaluate the association between circadian rhythm-disrupting behaviours, blood pressure (SBP, DBP) and inflammatory markers in >350,000 adults with European white British ancestry. The independent U-shaped relationship between sleep length and SBP/DBP is most prominent with a low inflammatory status. Poor sleep quality and permanent night shift work are also positively associated with SBP/DBP. Although fully adjusting for BMI in the linear regression model attenuated effect sizes, these associations remain significant. Two-sample Mendelian Randomisation (MR) analyses support a potential causal effect of long sleep, short sleep, chronotype, daytime napping and sleep duration on SBP/DBP. Thus, in the current study, we present a positive association between circadian rhythm-disrupting behaviours and SBP/DBP regulation in males and females that is largely independent of age.
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Affiliation(s)
- Monica Kanki
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Medicine (Alfred Health), Central Clinical School, Monash University, Clayton, VIC, Australia
| | - Artika P Nath
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Ruidong Xiang
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Stephanie Yiallourou
- Turner Institute for Brain and Mental Health, Department of Central Clinical School, Monash University, Clayton, VIC, Australia
| | - Peter J Fuller
- Centre of Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Timothy J Cole
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, Australia
| | - Rodrigo Cánovas
- Cambridge-Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Health and Biosecurity, Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia
| | - Morag J Young
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Department of Cardiometabolic Health, University of Melbourne, Melbourne, VIC, Australia.
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Xue P, Tan X, Benedict C. Association of poor sleep and HbA1c in metformin-treated patients with type 2 diabetes: Findings from the UK Biobank cohort study. J Sleep Res 2023; 32:e13917. [PMID: 37106473 DOI: 10.1111/jsr.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
The American Diabetes Association recommends a glycated haemoglobin target of less than 7% for treating type 2 diabetes mellitus. However, it is still being determined if poor sleep affects this therapeutic goal, despite being treated with the blood-glucose-lowering medication metformin. Thus, we used data from 5703 patients on metformin monotherapy participating in the UK Biobank baseline investigation between 2006 and 2010. We combined self-reported chronotype, daily sleep duration, insomnia, daytime sleepiness and snoring into a multidimensional poor sleep score ranging from 0 to 5, with higher scores indicating a less healthy sleep pattern. With each point increase on the poor sleep score scale, the odds of patients having an glycated haemoglobin of ≥ 7% increased by 6% (odds ratio [95% confidence interval], 1.06 [1.01, 1.11], p = 0.021). When examining the components of the poor sleep score separately, snoring was specifically associated with a glycated haemoglobin of ≥ 7% (1.12 [1.01, 1.25] versus no snoring, p = 0.038). However, adjusting for health and lifestyle conditions, such as body mass index, weekly physical activity level and hypertension status, eliminated the significant associations between the poor sleep score and snoring with glycated haemoglobin of ≥ 7%. Our findings suggest that poor sleep, specifically snoring, a symptom of obstructive sleep apnea, may interfere with the therapeutic goal of achieving a glycated haemoglobin below 7%. However, other factors known to be promoted by poor sleep, such as high body mass index, low physical activity and hypertension, may also contribute to the link between poor sleep and higher glycated haemoglobin levels.
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Affiliation(s)
- Pei Xue
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Xiao Tan
- Department of Big Data in Health Science, Zhejiang University School of Public Health and Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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Su Y, Ding N, Zhou Y, Yang G, Chai X. The association between bedtime at night and hypertension in adults. Postgrad Med 2022; 135:370-378. [PMID: 36333923 DOI: 10.1080/00325481.2022.2144031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This research was conducted to explore the association between bedtime at night and the prevalence of hypertension in adults. METHODS We conducted a cross-sectional study of 14,536 participants with data from the NHANES database. Bedtime was determined from the question in the sleep questionnaire: 'What time do you usually fall asleep on weekdays or workdays?.' Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, or diastolic blood pressure (DBP) ≥ 90 mmHg, or having been told by a doctor to have high blood pressure, or taking antihypertensive medication. We conducted a weighted multiple logistic regression analysis to explore the relationship between bedtime at night and the prevalence of hypertension in adults. RESULTS The association between bedtime and hypertension showed a significantly U-shaped relationship. People who went to bed at 23:00 had the lowest risk of developing hypertension (OR, 0.68 [95%CI, 0.58, 0.81]). This U-shaped association still existed in different genders. In males (n = 7159), the adjusted OR was still lowest at 23:00. However, the adjusted OR was lowest at 0:00 in females(n = 7377). The interaction effect between bedtime and gender was significant (P = 0.0187). CONCLUSION With the delay in bedtime, the association between bedtime and hypertension showed a significantly U-shaped relationship. Falling asleep at 23:00 has the lowest risk of developing hypertension.
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Affiliation(s)
- Yingjie Su
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Ning Ding
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Yang Zhou
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Guifang Yang
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
| | - Xiangping Chai
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
- Trauma center, Hunan Province, Changsha, Hunan Province, China
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Ji H, Zhang K, Lu Y, Kong X, Ma X. The efficacy of acupuncture with Lingguibafa acupoint selection in the treatment of insomnia: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2022; 101:e31515. [PMID: 36316895 PMCID: PMC9622694 DOI: 10.1097/md.0000000000031515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a major public health problem, insomnia has garnered much attention. Acupuncture, with dialectical acupoint selection (DAS), has been proved to be effective for insomnia, but there is no evidence of evidence-based medicine to prove the efficacy of Lingguibafa acupoint selection (LAS) for insomnia. This study is to evaluate the clinical efficacy of acupuncture with LAS in patient with insomnia. METHODS The PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Weipu Database for Chinese Technical Periodicals, Chinese Biomedical Database, and Wanfang Database were systematically searched from the inception dates to December 18, 2021. Randomized controlled trials of acupuncture with LAS versus acupuncture with DAS or acupuncture with LAS plus DAS versus acupuncture with DAS in patient with insomnia were included. Two review authors independently performed the data extraction and assessed study quality. A meta-analysis was performed using random-effects models to calculate relative risk and weighted mean difference for categorical and continuous variables, respectively. The primary efficacy outcome was improvement on Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included insomnia severity index, Epworth sleepiness scale, Hamilton anxiety scale, Hamilton Depression Scale (HAMD), and total effective rate. RESULTS A total of 7 trials with 468 patients fulfilled the selection criteria. The pooled results indicated that acupuncture with LAS plus DAS could reduce PSQI score by 2.08 (1.60 after excluding heterogeneity) compared to acupuncture with DAS. Acupuncture with LAS plus DAS had high reliability in sleep quality, sleep latency, sleep time and daytime function, but showed no significant effect on sleep disorder and hypnotic drug. For total effective rate, acupuncture with LAS plus DAS or acupuncture with LAS was better than acupuncture with DAS, but the conclusion was less credible. CONCLUSION Acupuncture with LAS is significantly associated with improvements in several sleep parameters, primarily evident on the PSQI score. Nevertheless, considering the poor methodological quality, trials employing appropriate randomization concealment and blinding based on a larger sample size are needed in the future.
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Affiliation(s)
- Haiyang Ji
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ke Zhang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan Shandong, China
| | - Yunqiong Lu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiehe Kong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Xiaopeng Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
- * Correspondence: Xiaopeng Ma, Shanghai Research Institute of Acupuncture and Meridian, No. 650 Wanping South Road, Xuhui District, Shanghai 200030, China (e-mail: )
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