Sleep characteristics associated with nocturnal blood pressure nondipping in healthy individuals: a systematic review

Philippa Eileen Forshaw, Arron Taylor Lund Correia, Laura Catherine Roden, Estelle Victoria Lambert, Dale Elizabeth Rae

    Research output: Contribution to journalReview articlepeer-review

    3 Citations (Scopus)
    20 Downloads (Pure)


    OBJECTIVE: The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease.

    METHODS: The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review.

    RESULTS: Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals.

    CONCLUSION: While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one's sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.

    Original languageEnglish
    Pages (from-to)357-370
    Number of pages14
    JournalBlood Pressure Monitoring
    Issue number6
    Early online date12 Sept 2022
    Publication statusPublished - 1 Dec 2022

    Bibliographical note

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    This document is the author’s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.


    • adults
    • ambulatory blood pressure monitoring
    • blood pressure dipping
    • circadian rhythms
    • sleep

    ASJC Scopus subject areas

    • Internal Medicine
    • Cardiology and Cardiovascular Medicine
    • Assessment and Diagnosis
    • Advanced and Specialised Nursing


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