Aging and the Effect of Total Sleep Deprivation on Blood Pressure and Baroreflex Sensitivity

Lekkerkerker, S. (Selma) (2013) Aging and the Effect of Total Sleep Deprivation on Blood Pressure and Baroreflex Sensitivity. thesis, Medicine.

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Abstract

Hypertension is a worldwide problem with increasing prevalence with aging. Short-term blood pressure (BP) regulation is mainly controlled by the baroreflex. Sensitivity of the baroreflex (BRS) decreases with age. Reduced BRS is related to increased risk of sudden cardiac death, and higher mortality after myocardial infarction. During normal sleep, BP and heart rate (HR) decrease and BRS increases. Short sleep duration is associated with higher BP, coronary heart disease, and stroke. We hypothesized that total sleep deprivation (TSD) will cause increased BP, BP variability (BPV) and heart rate (HR), decreased sensitivity of the vagal baroreflex, and increased time delay of the baroreflex, and that age will exacerbate these effects. Participants were randomly placed in the experimental group (n=16), undergoing a 66-hour vigil, or the control group (n=6), sleeping 9 hours per night. Beat-by-beat BP was measured using Portapres during 3 24-hour periods: adaptation, experimental and recovery. BRS was calculated with the cross-correlation method. During the experimental period TSD was compared to normal sleep. Within the TSD group, younger (<40 years) and older (≥40 years) subjects were compared. TSD causes mean arterial pressure (MAP), BPV, and HR to increase during nighttime. BPV is also elevated during daytime TSD. The amplitude of night/day variation of HR decreases during TSD. During the experimental period there are no differences in MAP, BRS, and timing of the baroreflex between the age groups. HR is higher in younger subjects during nighttime. The decreased amplitude of night/day variation of HR was most pronounced in younger subjects. During the adaptation period BRS increases during nighttime in younger, but not in older subjects. Older subjects have an increased time delay of the baroreflex. During sleep deprivation, younger subjects show a decreased day/night variation in BRS and time delay of the baroreflex increases. There is no additional effect of TSD in older subjects. These changes cause a similar night/day variation of BRS in younger and older subjects during TSD. In younger subjects, TSD is a model for aging for the characteristics of BRS and HR.

Item Type:	Thesis (Thesis)
Supervisor name:	Horst, PhD
Supervisor name:	Mullington, PhD and Department of Neurology and Beth Israel Deaconess Medical Center and Harvard Medical School
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:47
Last Modified:	25 Jun 2020 10:47
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/877

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