Sleep Dynamic Therapy

This report on a research article in the journal Hypertension discusses the connection between short sleep duration and an increase in high blood pressure in women. One of the key discussion points was the age factor (average 55 years-old) in the sample of women, and its implication of a menopausal effect. This point is interesting in the context of Guilleminault’s study on peri-menopausal women with insomnia who suffered from SDB, especially in the form of UARS. Remarkably, the research article in Hypertension does not cite Guilleminault’s work nor does it connect the dots between insomnia, UARS, and menopause as the more parsimonious path to hypertension. Conceivably, severe insomnia with sympathetic activation could cause increased vascular tone and resultant high blood pressure. Yet, given the knowledge that many peri-menopausal women with insomnia suffer from SDB and that SDB has been linked to hypertension, I would have liked to have seen more discussion on this hypothesis. Last, in their call for future studies, no mention was made for the need for overnight sleep studies (polysomnography), which, unfortunately, continues to reflect the outdated paradigm that insomnia patients do not need to be studied in the sleep lab.