Nebivolol is Different From Atenolol in Terms of Impact Onto Sleep
Alim Erdem, M.D., Mehmet Birhan Yılmaz, M.D., Okan Onur Turgut, M.D., Ahmet Yılmaz, M.D., Kenan Yalta, M.D., ‹zzet Tando€an, M.D.
B AC K G R O U N D
Sleep is a basic physiologic process, inevitable for life. Sleep disturbances have consistently been shown to impact many aspects of quality of life. Beta blockers are accused of effecting various parameters of sleep negatively. However, Nebivolol with its unique properties is generally considered separately. A study was conducted to compare the influence of Atenolol and Nebivolol onto sleep quality among patients with Stage I hypertension.
M ET H O D S
50 consecutive patients, who were recently diagnosed with Stage 1 hypertension (defined as the average of seated systolic blood pressure (BP) >140 mmHg but 90 mmHg but
R E S U LT S
23 patients in the Nebivolol group and 23 patients in the Atenolol group (mean age: 41±6 vs. 41±4 years, p=0.665) completed the study as well as the follow up. Both treatments normalised the blood pressure. PSQI total score was significantly improved (5.78±2.56 vs. 4.48±1.78, p=0.002) by Nebivolol therapy, whereas; PSQI total score was worsened (5.39±2.04 vs. 6.00±1.09, p=0.027) by Atenolol therapy.
CO N C L U S I O N S
N eb ivolol was shown to imp r ove the sleep quality in terms of PSQI scores in rel at ively young hypert e ns ive patients with mild hypert e nsion, wher eas Aten olol was shown to worsen it.
Keywords: Atenolol; hypertension; nebivolol; sleep/drug effects ; sleep quality; Pittsburgh Sleep Quality Index.
The Anatolian Journal of Clinical Investigaton. An Open Access Article.
Mild-to-moderate hypertension usually does not greatly impair quality of life (QoL) measures.( 1) This may partly explain the low rates of successfully treated hypertensive patients( 2) and also the low compliance rates to prescribed drugs among these patients.( 3) Antihypertensive drugs have been shown to be beneficial in reducing cardiovascular morbidity and mortality mainly by their blood pressure reducing effect.( 4) However, lack of effective compliance can reduce the benefits of treatment. Therefore, QoL measure becomes an integral part of use of drugs in order to improve compliance.( 5)
Sleep is a basic physiologic process, inevitable for life. Sleep disturbances have consistently been shown to influence many aspects of quality of life, including general health, physical functions, cognitive functions, daily activities, and work performance negatively.( 6) Various quality of sleep parameters were shown to be affected negatively by beta blockers. Vivid and bizarre dreams, hallucinations, increased awakening, reduced dreaming are all known side effects of beta blockers.( 7)
Nebivolol has been classified as a third generation beta blocker with vasodilating properties. It is a selective beta 1-blocker with vasodilatory property through release of nitric oxide without sympathomimetic activity.( 8 ) Nebivolol was shown to have a favorable side effect profile and general QoL, not different from the placebo.( 9) A study was conducted to compare the influence of Atenolol (reference selective beta blocker for comparison) and Nebivolol onto sleep quality among patients with Stage I hypertension.