Marital Conflict and Nocturnal Blood Pressure Dipping in Military Couples

Published in: Health Psychology, 2016

by Wendy M. Troxel, Amy Soo Jin DeSantis, Anne Germain, Daniel J. Buysse, Karen A. Matthews

Read More

Access further information on this document at Health Psychology

This article was published outside of RAND. The full text of the article can be found at the link above.


Our goal was to examine the association between marital conflict and nocturnal blood pressure dipping (NBP) in Iraq/Afghanistan healthy veterans and their partners and to determine whether sleep disturbances mediate such associations.


The sample consisted of 25 heterosexual couples comprised of male veterans and their female civilian spouses/partners. Blood pressure was measured across 48 hr, and NBP was calculated as the ratio of sleep/wake mean arterial pressure (MAP). Marital conflict was assessed by questionnaire. Sleep was assessed via in-home polysomnography (PSG). Posttraumatic stress disorder (PTSD) diagnosis was determined via clinician interview and was included as a covariate in all analyses, along with body mass index, age, gender, and deployment characteristics.


Higher marital conflict was associated with higher MAP ratios (β = .74, p < .01), with the effect stronger among women (β = −0.68, p < .05, for gender interaction). Among women only, for each SD increase in marital conflict there was a .82 increase in MAP ratio (p < .01). This association was reduced to nonsignificance after adjustment for PSG-assessed sleep efficiency.


Consistent with limited prior work in civilian samples, higher marital conflict in military couples was associated with blunted NBP, particularly among women. These findings highlight the importance of considering the health and well-being of both veterans and their partners in the aftermath of war, as well as the importance of considering nighttime physiological pathways that are relevant to cardiovascular disease risk.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.