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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Effects of Ambulatory Blood Pressure Monitoring During Polysomnography on Sleep Indices and EEG Power

5 affiliations
  1. 1Department of Electronic Engineering, Hanyang University, Seoul 04763, Republic of Korea
  2. 2Department of Biomedical Engineering, Hanyang University, Seoul 04763, Republic of Korea
  3. 3Department of Biomedical Engineering, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
  4. 4Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
  5. 5Department of Neurology, College of Medicine, Hanyang University Seoul Hospital, Seoul 04763, Republic of Korea

Abstract

Background/Objectives: Ambulatory blood pressure monitoring (ABPM) may disturb sleep during polysomnography (PSG), and the first-night effect (FNE) can complicate interpretation. We evaluated changes associated with ABPM and FNE across whole nights and individual measurements. Methods: This secondary analysis included 72 nominally healthy adults in a balanced two-night crossover, with ABPM on one randomly assigned night. Linear mixed-effects models estimated associations with PSG-derived sleep indices, a composite sleep quality index (SQI), and relative electroencephalographic (EEG) power. Analyses of individual measurements summarized EEG changes, sleep-stage transitions, and automated arousal detections. Benjamini–Hochberg false discovery rate (BH-FDR) adjustment was applied within defined analysis families. Results: FNE and ABPM were associated with lower SQI (β = −0.049 and −0.051, respectively; both BH-adjusted p = 0.028). FNE was associated with altered sleep continuity and architecture, whereas ABPM was associated with higher light-sleep and lower N3-sleep percentages and higher whole-night relative theta power. In the Night 2 paired analysis, relative delta power was lower and relative alpha, beta, and gamma power were higher during ABPM than before ABPM (all BH-adjusted p < 0.01); the theta difference did not reach significance (BH-adjusted p = 0.0632). Of 655 eligible ABPM measurements beginning during sleep, 395 (60.3%) contained at least one arousal detection within the 2 min measurement window. Conclusions: These detections indicate temporal co-occurrence and do not establish that cuff inflation caused arousal. Concurrent ABPM and study-night order should be considered when interpreting PSG. An adaptation PSG night may be considered when feasible, as may cuffless blood pressure monitoring once its accuracy has been established for the intended setting.

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BibTeX
@article{kim2026effects,
  title = {{Effects of Ambulatory Blood Pressure Monitoring During Polysomnography on Sleep Indices and EEG Power}},
  author = {Jeonghoon Kim and Donghun Kang and Jongshill Lee and Junhee Han and Jeyeon Lee and Myung-Kyu Yi and Byung Sik Kim and Hyun-Jin Kim and Jinseok Park and Jeong-Hun Shin and In Young Kim},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218759},
  url = {https://www.mdpi.com/2077-0383/15/21/8759},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Effects of Ambulatory Blood Pressure Monitoring During Polysomnography on Sleep Indices and EEG Power
AU  - Jeonghoon Kim
AU  - Donghun Kang
AU  - Jongshill Lee
AU  - Junhee Han
AU  - Jeyeon Lee
AU  - Myung-Kyu Yi
AU  - Byung Sik Kim
AU  - Hyun-Jin Kim
AU  - Jinseok Park
AU  - Jeong-Hun Shin
AU  - In Young Kim
PY  - 2026
DA  - 2026/11/09
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218759
UR  - https://www.mdpi.com/2077-0383/15/21/8759
AB  - Background/Objectives: Ambulatory blood pressure monitoring (ABPM) may disturb sleep during polysomnography (PSG), and the first-night effect (FNE) can complicate interpretation. We evaluated changes associated with ABPM and FNE across whole nights and individual measurements. Methods: This secondary analysis included 72 nominally healthy adults in a balanced two-night crossover, with ABPM on one randomly assigned night. Linear mixed-effects models estimated associations with PSG-derived sleep indices, a composite sleep quality index (SQI), and relative electroencephalographic (EEG) power. Analyses of individual measurements summarized EEG changes, sleep-stage transitions, and automated arousal detections. Benjamini–Hochberg false discovery rate (BH-FDR) adjustment was applied within defined analysis families. Results: FNE and ABPM were associated with lower SQI (β = −0.049 and −0.051, respectively; both BH-adjusted p = 0.028). FNE was associated with altered sleep continuity and architecture, whereas ABPM was associated with higher light-sleep and lower N3-sleep percentages and higher whole-night relative theta power. In the Night 2 paired analysis, relative delta power was lower and relative alpha, beta, and gamma power were higher during ABPM than before ABPM (all BH-adjusted p < 0.01); the theta difference did not reach significance (BH-adjusted p = 0.0632). Of 655 eligible ABPM measurements beginning during sleep, 395 (60.3%) contained at least one arousal detection within the 2 min measurement window. Conclusions: These detections indicate temporal co-occurrence and do not establish that cuff inflation caused arousal. Concurrent ABPM and study-night order should be considered when interpreting PSG. An adaptation PSG night may be considered when feasible, as may cuffless blood pressure monitoring once its accuracy has been established for the intended setting.
SN  - 2077-0383
ER  -