Pengukuran Risiko Gangguan Tidur pada Penggunaan Angiotensin Converting Enzyme Inhibitor dan Calcium Channel Blocker: Case Control Study di Puskesmas Dau, Malang
Abstract
Gangguan tidur atau insomnia yang muncul pada pasien hipertensi dapat disebabkan oleh efek samping obat-obat antara lain golongan Angiotensin Converting Enzyme Inhibitor (ACEI) dan Calcium Channel Blocker (CCB), namun besarnya pengaruh masing-masing golongan belum banyak diperbandingkan. Oleh karena itu, dilakukan penelitian dengan menggunakan rancangan case control untuk menilai risiko penggunaan ACEI dan CCB terhadap angka kejadian insomnia. Data demografi dan status insomnia dikumpulkan melalui Lembar Pengumpul Data (LPD) dan kuesioner Athens Insomnia Scale (AIS), kemudian dilakukan analisis univariat, bivariat, dan multivariat. Hasil analisis menunjukkan bahwa pada kelompok usia 56–60 tahun, pasien yang menjalani pengobatan dengan ACEI memiliki risiko insomnia lebih kecil yaitu sekitar 0,38 kali (p=0,026, 95% CI=0,15–0,94) dibandingkan dengan pasien lain yang menggunakan CCB, sedangkan pada kelompok kategorial yang lain tidak ditemukan hubungan yang signifikan. Dengan demikian, pemantauan efek samping insomnia menjadi penting untuk dilakukan oleh tenaga kesehatan terutama pada pasien yang menjalani pengobatan dengan CCB pada usia 56–60 tahun.
Kata kunci: ACE inhibitor, calcium channel blocker, case control, gangguan tidur
A Measurement of Sleep Disorder in the Use of Angiotensin Converting Enzyme Inhibitor and Calcium Channel Blocker: A Case Control Study at Dau Public Health Center, Malang
Abstract
Sleep disorder or insomnia arisen in hypertensive patients might be derived as a side effect of antihypertensive mediations such as Angiotensin Converting Enzyme Inhibitor (ACEI) and Calcium Channel Blocker (CCB), but the influence of each group had not been much compared. Therefore, a research was conducted using case control design to assess the risk of using ACEI and CCB against the incidence rate of insomnia. Demographic data and insomnia status were collected through Data Collector Sheet and Athens Insomnia Scale (AIS) questionnaire before univariate, bivariate, and multivariate analysis was conducted. The result showed that in the age group of 56–60 years patients undergoing treatment with ACEI have a smaller risk of insomnia of approximately 0.38 times (p=0.026, 95% CI=0.15–0.94) compared to the other patients who were treated with CCB, while in other categorial groups, no significant relationship was found. Thus, the monitoring of insomnia side effects becomes important to be conducted by healthcare professional especially in patients undergoing treatment with CCB at the ages of 56–60 years.
Keywords: ACE inhibitor, calcium channel blocker, case control, sleep disorder
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Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar 2013. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.
Butt DA, Harvey PJ. Benefits and risks of antihypertensive medications in the elderly. J Intern Med. 2015;278(6):599-626. doi: 10.1111/joim.12446.
Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG et al. Clinical practice guidelines for the management of hypertension in the community: A statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens. 2014;16(1):14–26. doi: 10.1111/jch.12237.
Nerbass FB, Pedrosa RP, Genta PR, Drager LF, Lorenzi-Filho G. Calcium channel blockers are independently associated with short sleep duration in hypertensive patients with obstructive sleep apnea. J Hypertens. 2011;29(6):1236–41. doi: 10.1097/HJH.0b013e3283462e8b
Gupta MA, Knapp K. Cardiovascular and psychiatric morbidity in Obstructive Sleep Apnea (OSA) with Insomnia (sleep apnea plus) versus obstructive sleep apnea without insomnia: A case-control study from a nationally representative US sample. PLoS One. 2014;9(3):e90021. doi: 10.1371/journal.pone.0090021
Cicolin A, Mangiardi L, Mutani R, Bucca C. Angiotensin-converting enzyme inhibitors and obstructive sleep apnea. Mayo Clin Proc. 2006;81(1):53–5. doi: 10.4065/81.1.53
van Dijk M, Donga E, van Dijk JG, Lammers GJ, van Kralingen KW, Dekkers OM, M. et al. Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus. Diabetologia. 2011;54(8):1967–76. doi: 10.1007/s00125-011-2184-7.
Soldatos CR, Dikeos DG, Paparrigopoulos TJ. The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res. 2003; 55(3):263–7. doi: 10.1016/s0022-3999(02)00604-9
Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48(6):555–60. doi: 10.1016/s0022-3999(00)00095-7
R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2018.
Makarem N, Shechter A, Carnethon MR, Mullington JM, Hall MH, Abdalla M, et al. Sleep duration and blood pressure: Recent advances and future directions. Curr Hypertens Rep. 2019;21(5):33. doi: 10.1007/s11906-019-0938-7.
Grandner MA, Martin JL, Patel NP, Jackson NJ, Gehrman PR, Pien G. et al. Age and sleep disturbances among American men and women: Data from the U.S. Behavioral Risk Factor Surveillance System. Sleep. 2012;35(3):395–406. doi: 10.5665/sleep.1704.
Jaussent I, Dauvilliers Y, Ancelin ML, Dartigues JF, Tavernier B, Touchon J, et al. Insomnia symptoms in older adults: Associated factors and gender differences. Am J Geriatr Psychiatry. 2011;19(1):88–97. doi: 10.1097/JGP.0b0 13e3181e049b6.
Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2018;13(2):147–59. doi: 10.1016/j.jsmc.2018.02.001.
He L Wang B, Lang WY, Xue J, Zhao DL, Li GF, et al. Genetically-reduced serum ACE activity might be a causal risk factor for obstructive sleep apnea syndrome: A meta-analysis. Sci Rep. 2015;5:15267. doi: 10.1038/srep15267
Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep heart health study. J Am Med Assoc. 2000;283(14):1829–36. doi: 10.1001/jama.283.14.1829
Friedman O, Bradley TD, Logan AG. Influence of lower body positive pressure on upper airway cross-sectional area in drug-resistant hypertension. Hypertension. 2013;61(1):240-5. doi: 10.1161/HYPERTENSIONAHA.112.203547
Chiu KL, Ryan CM, Shiota S, Ruttanaumpawan P, Arzt M, Haight JS, et al. Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med. 2006;174(12):1378-83. doi: 10.1164/rccm.200607-927OC
Jiménez JA, Greenberg BH, Mills PJ. Effects of heart failure and its pharmacological management on sleep. Drug Discov Today Dis Models. 2012;8(4):161–166. doi: 10.1016/j.ddmod.2011.02.006
Walsh JT, Andrews R, Starling R, Cowley AJ, Johnston ID, Kinnear WJ. Effects of captopril and oxygen on sleep apnoea in patients with mild to moderate congestive cardiac failure. Br Heart J. 1995;73(3):237–41. doi: 10.1136/hrt.73.3.237
Sangole NV, Dadkar VN. Adverse drug reaction monitoring with angiotensin converting enzyme inhibitors: A prospective, randomized, open-label, comparative study. Indian J Pharmacol. 2010;42(1):27–31. doi: 10.4103/0253-7613.62408.
Lin WL, Chen YR, Lai CT, Yamada S, Liu SH, Chou YH, et al. Neural mechanism of angiotensin-converting enzyme inhibitors in improving heart rate variability and sleep disturbance after myocardial infarction. Sleep Med. 2018;48:61–9. doi: 10.1016/j.sleep.2018.04.007.
DOI: https://doi.org/10.15416/ijcp.2019.8.3.166
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