Abstract
Abstract Introduction Insomnia with objective short sleep duration (ISSD) has been associated with higher risk of cardiometabolic morbidity. In this study, we examined the association between ISSD, also based on subjective sleep duration, with incident hypertension in the Sleep Heart Health Study (SHHS). Methods We analyzed data from 1413 participants free of hypertension or sleep apnea at baseline from the SHHS with a median follow-up duration of 5.1 years. Insomnia symptoms were defined based on difficulty falling asleep, difficulty returning to sleep, early morning awakening, or sleeping pill use more than half days in a month. Objective short sleep duration was defined as polysomnography-measured total sleep time < 6 hours. Incident hypertension was defined based on blood pressure measures and/or use of antihypertensive medications at follow-up. Results Insomnia subjects who slept objectively < 6 hours had significantly higher odds of incident hypertension compared to normal sleeping subjects who slept ≥6 hours (OR=2.00, 95% CI=1.09-3.65) or < 6 hours (OR=2.00, 95%CI=1.06-3.79) or insomnia subjects who slept ≥6 hours (OR=2.79, 95%CI= 1.24-6.30). Insomnia subjects who slept ≥6 hours or normal sleepers who slept < 6 hours were not associated with increased risk of incident hypertension compared to normal sleepers who slept ≥6 hours. Finally, insomnia subjects who self-reported sleeping < 6 hours were not associated with significantly increased odds of incident hypertension. Conclusion These data further support that the ISSD phenotype based on objective, but not subjective measures is, similar to sleep apnea. Support (if any) The Sleep Heart Health Study (SHHS) was supported by National Heart, Lung, and Blood Institute cooperative agreements U01HL53916 (University of California, Davis), U01HL53931 (New York University), U01HL53934 (University of Minnesota), U01HL53937 and U01HL64360 (Johns Hopkins University), U01HL53938 (University of Arizona), U01HL53940 (University of Washington), U01HL53941 (Boston University), and U01HL63463 (Case Western Reserve University). The National Sleep Research Resource was supported by the National Heart, Lung, and Blood Institute (R24 HL114473, 75N92019R002).
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