Alberto R Ramos1, Jia Weng2, Douglas M Wallace3, Megan R Petrov4, William K Wohlgemuth5, Daniela Sotres-Alvarez6, Jose S Loredo7, Kathryn J Reid8, Phyllis C Zee8, Yasmin Mossavar-Rahmani9, Sanjay R Patel10. 1. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: aramos@med.miami.edu. 2. Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA. 3. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL. 4. College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ. 5. Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL; Psychology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL. 6. Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC. 7. Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, CA. 8. Department of Neurology, Northwestern University, Chicago, IL. 9. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY. 10. Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: The aim of this study was to evaluate the association between actigraphy-based measures of sleep and prevalent hypertension in a sample of US Latinos. METHODS: We analyzed data from 2,148 participants of the Sueño Sleep Ancillary Study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), who underwent 1 week of wrist actigraphy to characterize sleep duration, sleep efficiency, sleep fragmentation index, and daytime naps. Insomnia was defined as an Insomnia Severity Index ≥ 15. Hypertension was defined based on self-reported physician diagnosis. Survey linear regression was used to evaluate the association of sleep measures with hypertension prevalence. Sensitivity analyses excluded participants with an apnea-hypopnea index (AHI) ≥ 15 events/h. RESULTS: The mean age was 46.3 ± 11.6 years, and 65% of the sample consisted of women. The mean sleep duration was 6.7 ± 1.1 hours. Thirty-two percent of the sample had hypertension. After adjusting for age, sex, ethnic background, site, and AHI, each 10% reduction in sleep efficiency was associated with a 7.5% (95% CI, -12.9 to -2.2; P = .0061) greater hypertension prevalence, each 10% increase in sleep fragmentation index was associated with a 5.2% (95% CI, 1.4-8.9; P = .0071) greater hypertension prevalence, and frequent napping was associated with a 11.6% greater hypertension prevalence (95% CI, 5.5-17.7; P = .0002). In contrast, actigraphy-defined sleep duration (P = .20) and insomnia (P = .17) were not associated with hypertension. These findings persisted after excluding participants with an AHI ≥ 15 events/h. CONCLUSIONS: Independent of sleep-disordered breathing, we observed associations between reduced sleep continuity and daytime napping, but not short sleep duration, and prevalent hypertension.
BACKGROUND: The aim of this study was to evaluate the association between actigraphy-based measures of sleep and prevalent hypertension in a sample of US Latinos. METHODS: We analyzed data from 2,148 participants of the Sueño Sleep Ancillary Study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), who underwent 1 week of wrist actigraphy to characterize sleep duration, sleep efficiency, sleep fragmentation index, and daytime naps. Insomnia was defined as an Insomnia Severity Index ≥ 15. Hypertension was defined based on self-reported physician diagnosis. Survey linear regression was used to evaluate the association of sleep measures with hypertension prevalence. Sensitivity analyses excluded participants with an apnea-hypopnea index (AHI) ≥ 15 events/h. RESULTS: The mean age was 46.3 ± 11.6 years, and 65% of the sample consisted of women. The mean sleep duration was 6.7 ± 1.1 hours. Thirty-two percent of the sample had hypertension. After adjusting for age, sex, ethnic background, site, and AHI, each 10% reduction in sleep efficiency was associated with a 7.5% (95% CI, -12.9 to -2.2; P = .0061) greater hypertension prevalence, each 10% increase in sleep fragmentation index was associated with a 5.2% (95% CI, 1.4-8.9; P = .0071) greater hypertension prevalence, and frequent napping was associated with a 11.6% greater hypertension prevalence (95% CI, 5.5-17.7; P = .0002). In contrast, actigraphy-defined sleep duration (P = .20) and insomnia (P = .17) were not associated with hypertension. These findings persisted after excluding participants with an AHI ≥ 15 events/h. CONCLUSIONS: Independent of sleep-disordered breathing, we observed associations between reduced sleep continuity and daytime napping, but not short sleep duration, and prevalent hypertension.
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