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[OP.7D.03] CUFF-BASED AMBULATORY BLOOD PRESSURE MEASUREMENT CAUSES AROUSAL REACTIONS AND RAISES SYSTOLIC BLOOD PRESSURE AT NIGHT – COMPARISON WITH BEAT-TO-BEAT AND CUFF-LESS METHOD

Objective: Cuff-based ABPM causes arousal reactions during sleep due to inflation of the cuff that come along with sympathetic activation and increases in SBP. This leads to an overestimate of the actual SBP during sleep. If the sympathetic tonus is already raised, like in apneic patients, an arousal leads to a decrease in SBP. This study aimed to assess the effect of cuff-based ABPM on sleep and SBP behaviour at night. We compared nocturnal SBP values using cuff-based ABPM versus a beat-to-beat and cuff-less ABPM based on pulse transit time (PTT). Figure. No caption available. Design and method: SBP was measured overnight in 40 adults (18 women, mean age 51 ± 16 years, BMI 28 ± 5 kg/m2) using an oscillometric ABPM (Mobil-O-Graph, IEM) with measurement intervals every 30 min. Simultaneously, BP was recorded beat-to-beat based on PTT (SOMNOtouch NIBP, SOMNOmedics GmbH) on the contralateral arm. In addition we recorded a 3-channel ECG, motoric activity, finger plethysmogram, oxygen saturation and the cuff pressure to synchronize both methods. An automatic sleep/wake analysis based on the activity profile revealed true SBP values during sleep. SBP increases due to cuff inflation were assessed using the difference of mean SBP over 3 sec before cuff inflation and the maximum SBP during cuff in-/deflation. Results: In total we analysed 556 SBP cuff recordings. We found insignificant SBP rises of 0–4 mmHg in 50% of all cuff recordings, likely due to respiratory variations. Significant SBP increases of 5–8 mmHg were found in 27%, increases of 9–12 mmHg in 14% and increases > 12 mmHg in 9% of all cuff inflations. A SBP decrease was observed in 2% of all recordings. Conclusions: This study shows that cuff-based ABPM during sleep disturbs sleep architecture, causing arousals, and induces significant increases in SBP. We found considerable SBP increases > 9 mmHg in 23% of all cuff recordings. Given that cuff-based ABPM is a cause of sleep disturbance, the continuous and non-reactive PTT method is of great clinical importance especially during night-time.