The association between sleep disturbances and blood pressure variability: a review of the literature.

STUDY OBJECTIVES: Sleep disturbances are an underrecognized public health issue that results in various adverse outcomes and disturbed quality of life. Blood pressure variability (BPV) is an emerging entity in assessing cardiovascular disease risk and accumulating evidence suggests that BPV is closely associated with end-organ damage. This review aims to explore the association between sleep disturbances and BPV. METHODS: A comprehensive systematic literature search was conducted electronically using Web of Science, Ovid MEDLINE, , and SCOPUS. The electronic search was restricted to relevant English-language studies published between 1985 and August 2020. Most studies were prospective cohorts in design. After applying eligibility criteria, 29 articles were included for synthesis. RESULTS: This review shows that sleep disturbances are linked to short-term, midterm, and long-term BPV. Restless legs syndrome, shift work, insomnia, short sleep, long sleep, obstructive sleep apnea, and sleep deprivation were all positively associated with systolic blood pressure or diastolic blood pressure fluctuations. CONCLUSIONS: Given the prognostic implications of BPV and sleep disturbances on cardiovascular mortality, recognizing and treating both disorders is essential. More research is needed to examine the impact of sleep disorder treatment on BPV and cardiovascular mortality. CITATION: Al Haddad N, Costanian C, Zibara V, et al. The association between sleep disturbances and blood pressure variability: a review of the literature. J Clin Sleep Med. 2023;19(8):1533-1544.

Epidemiology and management of hypertension among refugees in the Middle East: a review of the literature.

This review aims to explore the burden of hypertension among refugees in the Middle East by reporting its prevalence, risk factors and access to care. A comprehensive literature search was performed using Web of Science, Ovid MEDLINE, PubMed, SCOPUS, CINHAL+, WHO Regional Office for the Eastern Mediterranean (EMRO) and United Nations High Commissioner for Refugees (UNHCR) on articles spanning from 1948 until 2020. Most studies were cross-sectional in design. After applying eligibility criteria 17 articles and 4 reports were included. Findings showed that hypertension represents a major burden among refugees. Hypertension risk factors present among the refugee population included increased salt intake, physical inactivity, and smoking. The majority of hypertensive refugees sought care for their condition at the public health care services. Barriers to seeking care included high cost of healthcare, accessibility to provided services, and lack of knowledge for the need to seek care. Non-adherence to medication among refugees was primarily linked to cost and lack of symptoms. This review highlights the need for further studies to shed light on the importance of targeting hypertension among refugees, to lower morbidity and mortality, in addition to providing adequate healthcare services to this population.