Association Between Sleep Microstructure and Incident Hypertension in a Population‐Based Sample: The HypnoLaus Study

Abstract

Background Poor sleep quality is associated with increased incident hypertension. However, few studies have investigated the impact of objective sleep structure parameters on hypertension. This study investigated the association between sleep macrostructural and microstructural parameters and incident hypertension in a middle‐ to older‐aged sample. Methods and Results Participants from the HypnoLaus population‐based cohort without hypertension at baseline were included. Participants had at‐home polysomnography at baseline, allowing assessment of sleep macrostructure (nonrapid eye movement sleep stages 1, 2, and 3; rapid eye movement sleep stages; and total sleep time) and microstructure including power spectral density of electroencephalogram in nonrapid eye movement sleep and spindles characteristics (density, duration, frequency, amplitude) in nonrapid eye movement sleep stage 2. Associations between sleep macrostructure and microstructure parameters at baseline and incident clinical hypertension over a mean follow‐up of 5.2 years were assessed with multiple‐adjusted logistic regression. A total of 1172 participants (42% men; age 55±10 years) were included. Of these, 198 (17%) developed hypertension. After adjustment for confounders, no sleep macrostructure features were associated with incident hypertension. However, low absolute delta and sigma power were significantly associated with incident hypertension where participants in the lowest quartile of delta and sigma had a 1.69‐fold (95% CI, 1.00–2.89) and 1.72‐fold (95% CI, 1.05–2.82) increased risk of incident hypertension, respectively, versus those in the highest quartile. Lower spindle density (odds ratio, 0.87; 95% CI, 0.76–0.99) and amplitude (odds ratio, 0.98; 95% CI, 0.95–1.00) were also associated with higher incident hypertension. Conclusions Sleep microstructure is associated with incident hypertension. Slow‐wave activity and sleep spindles, 2 hallmarks of objective sleep continuity and quality, were inversely and consistently associated with incident hypertension. This supports the protective role of sleep continuity in the development of hypertension.

IIHP: Intelligent Incident Hypertension Prediction in Obstructive Sleep Apnea

“…However, there is a paucity of research investigating the relationship between sleep microarchitecture and the future development of hypertension in OSA. Berger et al recently reported that low delta power in non-REM sleep is independently associated with the risk of developing hypertension, confirming the previously noted relationship of SWS with incident hypertension [18]. Another study relied on complex feature engineering to examine 27 unselected clinical predictors, encompassing demographic characteristics, lifestyle behaviors, and OSA severity (apnea-hypopnea index; AHI, and oximetry indices) [19].…”

Objective sleep characteristics and hypertension: a community-based cohort study

“…It is noteworthy that the association between sleep duration (both objectively measured and subjectively reported) and hypertension has been a topic of debate in the literature (5)(6)(7)(8)(9)(10). Furthermore, certain studies have indicated that factors such as sleep efficiency, sleep quality, sleep microstructure, and fragmented sleep may also play a role in the development of hypertension (11)(12)(13)(14)(15), and poor subjective sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) was demonstrated an association with the incidence of hypertension (16). Sleep stages as objective sleep characteristics in humans are divided into rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep.…”