Wrist-type home blood pressure monitoring device improves usability and preserves sleep quality compared with conventional ambulatory monitoring

Objective: To compare usability and impact on sleep quality of a wrist-type home blood pressure monitoring (HBPM) device and a conventional upper-arm 24-h ambulatory blood pressure monitoring (ABPM) device. Methods: In this randomized crossover study, 60 community-dwelling individuals aged 50–80 years from the Reviving Early Detection of cardiovascular disease in the Utrecht Health Project (RED-LRGP) trial underwent wrist-type HBPM (Omron HEM-9601T) and upper-arm ABPM. HBPM included three nocturnal measurements per night (4 h after bedtime, 02 : 00, and 04 : 00) for five nights, with additional morning and evening daytime measurements. ABPM included a single 24-h period with hourly cuff inflations. After each monitoring period, participants completed the system usability scale (SUS) and visual analogue scale (VAS) for sleep quality. Linear mixed-effects models were used to compare usability (SUS) and sleep quality (VAS) between devices. Results: Sixty participants (mean age 58 years, 57% female, 23% hypertensive) completed questionnaires. HBPM showed higher usability (SUS 71.9 versus 52.4; P < 0.0001) and better sleep quality (VAS 74.6 versus 58.9; P < 0.0001) than ABPM. With five nightly HBPM measurements, nocturnal hypertension was detected in 27–39% of participants. This was 26% using single-night ABPM measurement. Nondipping patterns occurred in 7–14% with HBPM versus 25% using ABPM. Sixteen participants without obesity, hypertension, or other relevant comorbidities (27%) were classified as HBPM nondippers on ≥1 night. Conclusions: Wrist-type HBPM, combining multinight automated monitoring with high usability and minimal sleep disruption represents a feasible, patient-centered tool for home-based nocturnal BP assessment that has the potential to capture night-to-night BP variability.