Cross-sectional and prospective associations between irregular sleep and hypertension in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos

Kurzfassung

Introduction: Recent research suggests that maintaining a regular sleep-wake schedule is an important dimension of sleep health, in addition to adequate sleep duration and timing. The aim of this study was to evaluate cross-sectional and prospective associations between the day-to day regularity of sleep-wake patterns and hypertension in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Data from 2,124 adults, aged 19 – 64 years, who completed 1 week of wrist actigraphy in the Sueño Ancillary Study of the HCHS/SOL were used in cross-sectional analyses. Of those, 1,397 participants not meeting criteria for hypertension at the baseline HCHS/SOL visit attended HCHS/SOL Visit 2, with 271 incident cases and a mean follow-up time of 5.8 years. Complex survey regression models adjusting for, e.g., sleep duration and timing, were used to estimate (sex-specific) cross-sectional and prospective associations between irregular sleep (i.e., using two recent metrics, the Sleep Regularity Index (SRI) and Composite Phase Deviation (CPD)) and prevalence/incidence of hypertension (i.e., clinic systolic or diastolic blood pressure ³ 140/90 mmHg or current use of antihypertensive medications). Results: Participants were on average 40.7 (SE, 0.4) years old, with 51.4% being female and a mean BMI of 29.8 (0.2) kg/m2 . Mean prevalence and incidence of hypertension were 18.6%, respectively, 12.9%. In cross-sectional analyses, more irregular sleep (lower SRI/higher CPD) was significantly associated with a higher prevalence of hypertension: prevalence increased by 2.4% per 10-units decrease in SRI and by 3.6% per hour-increase in CPD (bSRI = -0.024, SE = 0.010, p = 0.006; bCPD = 0.036, SE = 0.012, p = 0.003). The CPD-effect was significant and more pronounced in males (bCPD = 0.057, SE = 0.021, p = 0.006) than females (bCPD = 0.015, SE = 0.013, p = 0.237; pinteraction = 0.106). In prospective analyses, no significant associations were observed between sleep regularity metrics and hypertension incidence (bSRI = -0.001, SE = 0.011, p = 0.894; bCPD = 0.009, SE = 0.011, p = 0.399). Conclusions: Sleep regularity is cross-sectionally associated with hypertension prevalence. Repeated, longer-term assessments in prospective cohorts are warranted to further elucidate any causal relationship between irregular sleep and cardiovascular health.