Night- Time Chronotherapy With Diuretics: Effect On Sleep Quality And Duration In Patients With Hypertension In Lusaka, Zambia.

Abstract

Poor sleep plays an important role in the prevalence of hypertension. It increases the prevalence rate to 60%. The night-time dosing of blood pressure-lowering drugs has yielded positive results. Scholars have rarely investigated the relationship between night-time dosing of diuretics and the quality of sleep. The study aimed at evaluating quality and duration of sleep while on night-time dosing of diuretics and determine the commonly used blood pressure-lowering medication at University Teaching Hospital. The study was a Prospective Cohort Study with 12 weeks follow-up. The sample consisted of 46 patients with hypertension and on a diuretic, 25 of whom were taking their medication in the evening at 10 PM (study group), and 18 were in the 10 AM dosing schedule as a control. Overall, 43 were included in the analysis. Baseline and follow-up at 2, 8 and 12 Sleep quality and duration, and blood pressure level were available for 43 (93.5%) individuals. The study recruited more women (76.1%) and the majority were on hydrochlorothiazide and amiloride combination (65.2%). The 10 PM dosing showed better in quality of sleep and duration, and blood pressure-lowering as the follow-up continued with a p-value of less than 0.05 for Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and for the blood pressure-lowering at 12 weeks. The study showed beneficial effects of 10 PM dosing of diuretics in hypertensive patients and the diuretic effect does not affect the quality and duration of sleep. Further, 10 PM dosing lowers the blood pressure significantly compared with 10 AM.