Self‐Reported Sleep Duration and Hypertension in Older Spanish Adults

López-Garcı́a, Esther; Faubel, Raquel; Guallar-Castillón, Pilar; León‐Muñoz, Luz M.; Banegas, José R.; Rodríguez‐Artalejo, Fernando

doi:10.1111/j.1532-5415.2009.02177.x

Cited by 52 publications

(44 citation statements)

References 22 publications

(48 reference statements)

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“…17 Therefore, while many epidemiological studies have suggested a relationship between sleep duration and HT in middleaged insomnia patients, the results are confl icting in the elderly population, with some studies stressing the independent risk of short sleep for HT 13,[18][19][20][21] and other studies fi nding no association. [22][23][24][25][26] The discrepancies among these reports likely stem…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 54%

Association of Self-Reported Sleep and Hypertension in Non-Insomniac Elderly Subjects

Sforza

Martin

Barthélemy

et al. 2014

Journal of Clinical Sleep Medicine

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Objectives: Sleep duration and sleep quality play important roles in the development of hypertension (HT) in middle-aged subjects, with controversial data in elderly. In this study, we investigated the link between HT and self-reported sleep in non-insomniac elderly subjects. Methods: We examined 500 participants without insomnia complaints aged 72 ± 1 years. An extensive instrumental evaluation was carried out, including 24-h blood pressure (BP) monitoring and an assessment of nocturnal BP dipping. Sleep duration and quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI). The subjects were stratifi ed into three groups according to sleep duration: short (< 6 h), normal (> 6h to < 8 h), and long (> 8 h) sleepers. A PSQI < 5 defi ned good sleepers (GS, n = 252), and a PSQI > 5 (n = 248) defi ned poor sleepers (PS). Results: PS represented 50% of the subjects, more frequently females. Compared to GS, PS did not differ in terms of HT, BP, barorefl ex sensitivity (BRS), and BP dipping. Short, normal, and long sleepers accounted for 28%, 42%, and 30% of subjects, with HT, BP values, BRS, and gender not differing between groups. No relationship was found between nocturnal BP values and self-reported sleep measures. Logistic regression analysis indicated that neither sleep duration nor sleep quality predicts the prevalence of HT, the body mass index being the only factor affecting this association. Clinical Trial Registration: ClinicalTrials.gov identifi ers NCT00759304 and NCT00766584 Conclusions: In a sample of non-insomniac elderly subjects, neither sleep duration nor sleep quality affected the prevalence of HT. These data argue against a relationship between selfreported sleep duration and quality and HT in elderly without insomnia. Keywords: hypertension, blood pressure, elderly, sleep duration, sleep quality, Pittsburgh Sleep Quality Index questionnaire Citation: Sforza E, Saint Martin M, Barthelemy JC, Roche F. Association of self-reported sleep and hypertension in non-insomniac elderly subjects. J Clin Sleep Med 2014;10(9):965-971.

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Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 54%

Association of Self-Reported Sleep and Hypertension in Non-Insomniac Elderly Subjects

Sforza

Martin

Barthélemy

et al. 2014

Journal of Clinical Sleep Medicine

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“…[14][15][16][17][18] Recently, growing evidence has suggested that short or long sleep duration might be associated with hypertension risk. [19][20][21][22][23][24][25][26][27][28][29][30][31][32] However, the results have been inconsistent, which could be due to the differences in the studied population, the study design and insufficient statistical power.…”

Section: Introductionmentioning

confidence: 85%

“…21 However, one study reported the OR value of short sleep duration for incident hypertension without the specific definition of sleep duration. 22 Hypertension was defined as systolic blood pressure/diastolic blood pressure (SBP/DBP)X140/90 mm Hg, current use of antihypertensive drugs or self-report of physician's diagnosis in all of the studies except for the one by van den Berg et al 24 (which defined hypertension as SBP/DBPX160/100 mm Hg or current use of antihypertensive drugs) and the study by Wang et al 31 (using SBP/DBPX130/85 mm Hg or physician diagnosed hypertension as the definition).…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Therefore, 14 papers involving 23 studies were included in the final metaanalysis. [19][20][21][22][23][24][25][26][27][28][29][30][31][32] Of them, six were prospective studies, including 9959 participants from United Kingdom (n ¼ 2), Spain (n ¼ 1) and United States (n ¼ 3), and 17 were cross-sectional studies, including 105 432 participants from the United Kingdom (n ¼ 2), Spain (n ¼ 1), Netherlands (n ¼ 1), Korea (n ¼ 2), Brazil (n ¼ 1), Germany (n ¼ 2), China (n ¼ 2), and the United States (n ¼ 6).…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Short sleep duration is associated with hypertension risk among adults: a systematic review and meta-analysis

et al. 2012

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A number of studies have reported that sleep duration might have an important role in the development of hypertension. However, the results have been inconsistent. In this study, a meta-analysis was performed to clarify the association between sleep duration and hypertension risk. PubMed, Embase and ISI web of science databases updated on 28 October 2011 were searched for eligible publications. Pooled odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) was calculated using a random-or fixed-effect model. Six prospective (N ¼ 9959) and seventeen cross-sectional (N ¼ 105432) studies were identified for the data analysis on sleep duration. The results indicated that short sleep duration was associated with an increased risk of prevalent hypertension (OR ¼ 1.20, 95% CI: 1.09-1.32, Po0.001), especially among subjects younger than 65 years and females. In addition, short sleep duration was also associated with an increased risk of incident hypertension among subjects younger than 65 years (RR ¼ 1.33, 95% CI: 1.11-1.61, P ¼ 0.002). Overall, there was a significant association between long sleep duration and the risk of prevalent hypertension (OR ¼ 1.11, 95% CI: 1.05-1.17, Po0.001). Further subgroup analysis also suggested a significant association between long sleep duration and the risk of prevalent hypertension among subjects younger than 65 years (OR ¼ 1.12, 95% CI: 1.06-1.19, Po0.001). The present meta-analysis indicated that short sleep duration was associated with an increased risk of hypertension in the overall polulation and incident hypertension among subjects younger than 65 years. In addition, long sleep duration might be associated with a risk of prevalent hypertension, especially among subjects younger than 65 years.

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“…Sleep deprivation among women (≤5 hours versus 7 hours/night) is associated with a greater risk of hypertension (odds ratio: 1.68, 95% confidence interval, 1.39–2.03) than that observed among men (odds ratio: 1.30; 95% confidence interval, 0.93–1.83); however, only 3 out of 23 reviewed studies presented findings stratified by sex 16, 17, 18, 19. Prolonged sleep onset latency increases the odds of hypertension by 300% (odds ratio: 3.27; 95% confidence interval, 1.20–8.96) 20.…”

Section: Introductionmentioning

confidence: 96%

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Aggarwal

Makarem

Shah

et al. 2018

JAHA

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BackgroundInsufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.Methods and ResultsWomen who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (P=0.04 and P=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6; P=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6; P=0.002 and β=8.26; P=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.ConclusionsThese findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02835261.

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Self‐Reported Sleep Duration and Hypertension in Older Spanish Adults

Abstract: Self-reported sleep duration is not associated with hypertension in older adults.

Cited by 52 publications

References 22 publications

Association of Self-Reported Sleep and Hypertension in Non-Insomniac Elderly Subjects

Association of Self-Reported Sleep and Hypertension in Non-Insomniac Elderly Subjects

Short sleep duration is associated with hypertension risk among adults: a systematic review and meta-analysis

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

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