Association of disrupted sleep with 24-hour blood pressure variability in caregivers

Soojung Ahn, Jill Howie-Esquivel, Eric M. Davis, Misook L. Chung, Jennifer M. Lobo, Jeongok G. Logan

Research output: Contribution to journalArticlepeer-review


Background: A growing body of research highlights the negative impact of caregiving on cardiovascular disease (CVD) risk. Objectives: This study aimed to examine associations of psychological symptoms and sleep quality with 24-hour blood pressure variability (BPV), which is an independent predictor of CVD, among family caregivers of community-dwelling individuals with chronic illness. Methods: For this cross-sectional study, we assessed caregiving burden and depressive symptoms using questionnaires and 7-day sleep quality (i.e., number of awakenings, wake after sleep onset, sleep efficiency) using an actigraph. The participants carried out a 24-hour ambulatory BP monitoring for systolic and diastolic BPV over 24 h and during awake/sleep times. We performed Pearson's correlations and multiple linear regression. Results: The analytic sample consisted of 30 caregivers (25 female; mean age 62 years). The number of awakenings during sleep was positively correlated with systolic BPV-awake (r = 0.426, p = 0.019) and diastolic BPV-awake (r = 0.422, p = 0.020). Sleep efficiency was negatively correlated with diastolic BPV-awake (r = -0.368, p = 0.045). Caregiving burden and depressive symptoms were not correlated with BPV. After controlling for age and mean arterial pressure, the number of awakenings was significantly associated with increased systolic BPV-24 h (β = 0.194, p = 0.018) and systolic BPV-awake (β = 0.280, p = 0.002), respectively. Conclusions: Caregivers’ disrupted sleep may play a role in increased CVD risk. While these findings should be confirmed in large clinical studies, improving sleep quality would need to be considered in CVD prevention for caregivers.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalHeart and Lung
StatePublished - Jul 1 2023

Bibliographical note

Funding Information:
This study is supported by the Council for the Advancement of Nursing Science/Southern Nursing Research Society (CANS/SNRS) Dissertation Research Grant . The funding source had no involvement in the conduct of the research and preparation of the article.

Publisher Copyright:
© 2023 Elsevier Inc.


  • Behavioral Symptoms
  • Blood pressure monitoring, Ambulatory
  • Caregivers
  • Health behavior
  • Sleep quality

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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