03456nas a2200445 4500008004100000022001400041245008900055210006900144260001300213300001200226490000700238520224900245653001002494653000902504653002202513653002002535653001902555653001602574653002802590653001102618653001902629653001102648653001702659653000902676653001602685653001502701653002402716653001002740653002902750653002202779653002402801100002402825700001902849700001802868700002202886700002002908700002402928700002302952856003502975 2006 eng d a0161-810500aAssociation of usual sleep duration with hypertension: the Sleep Heart Health Study.0 aAssociation of usual sleep duration with hypertension the Sleep  c2006 Aug a1009-140 v293 a

STUDY OBJECTIVES: Limited experimental data suggest that sleep restriction acutely elevates blood pressure; however, little is known about the relationship between usual sleep duration and hypertension. This study assesses the relationship between usual sleep duration and hypertension in a community-based cohort.

DESIGN: Cross-sectional observational study.

SETTING: The Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing.

PARTICIPANTS: Two thousand eight hundred thirteen men and 3097 women, aged 40 to 100 years.

INTERVENTIONS: None.

MEASUREMENTS AND RESULTS: Usual weekday and weekend sleep durations were obtained by questionnaire, and their weighted average were categorized as less than 6, 6 to less than 7, 7 to less than 8, 8 to less than 9, and 9 or more hours per night. Hypertension was defined as a systolic blood pressure of 140 mm Hg or greater, a diastolic blood pressure of 90 mm Hg or greater, or use of medication to treat hypertension. The relationship between sleep duration and hypertension was examined using categorical logistic regression with adjustment for age, sex, race, apnea-hypopnea index, and body mass index. Compared to subjects sleeping 7 to less than 8 hours per night, those sleeping less than 6 and between 6 and 7 hours per night had adjusted odds ratios for hypertension of 1.66 (95% confidence interval 1.35-2.04) and 1.19 (1.02-1.39), respectively, whereas those sleeping between 8 and 9 and 9 or more hours per night had adjusted odds ratios for hypertension of 1.19 (1.04-1.37) and 1.30 (1.04-1.62), respectively (p < .0001 for association of sleep duration with hypertension). These associations persisted when analyses were further adjusted for caffeine and alcohol consumption, current smoking, insomnia symptoms, depression symptoms, sleep efficiency, and prevalent diabetes mellitus or cardiovascular disease.

CONCLUSIONS: Usual sleep duration above or below the median of 7 to less than 8 hours per night is associated with an increased prevalence of hypertension, particularly at the extreme of less than 6 hours per night.

10aAdult10aAged10aAged, 80 and over10aBody Mass Index10aCohort Studies10aComorbidity10aCross-Sectional Studies10aFemale10aHealth Surveys10aHumans10aHypertension10aMale10aMiddle Aged10aOdds Ratio10aProspective Studies10aSleep10aSleep Apnea, Obstructive10aSleep Deprivation10aStatistics as Topic1 aGottlieb, Daniel, J1 aRedline, Susan1 aNieto, Javier1 aBaldwin, Carol, M1 aNewman, Anne, B1 aResnick, Helaine, E1 aPunjabi, Naresh, M uhttps://chs-nhlbi.org/node/91503055nas a2200373 4500008004100000022001400041245010300055210006900158260001300227300001200240490000700252520198600259653000902245653002802254653001602282653002802298653003802326653001102364653001902375653001102394653001702405653000902422653001602431653001502447653001102462653002002473653002902493653001802522100002202540700002402562700002402586710003502610856003602645 2008 eng d a0161-810500aSleep disordered breathing and hypertension: does self-reported sleepiness modify the association?0 aSleep disordered breathing and hypertension does selfreported sl c2008 Aug a1127-320 v313 a

STUDY OBJECTIVES: Epidemiologic studies that demonstrate increased risk of hypertension in persons with sleep disordered breathing indicate that only a minority of these persons report significant subjective sleepiness. Studies also suggest that presence of self-reported sleepiness may identify a subset of persons with sleep disordered breathing who are at greatest risk of cardiovascular sequelae, including hypertension. We explore whether self-reported sleepiness modifies the relationship between sleep disordered breathing and prevalent hypertension.

DESIGN: Cross-sectional.

SETTING: Multicenter study.

PARTICIPANTS: 6046 subjects from the Sleep Heart Health Study.

MEASUREMENTS: Polysomnography, systolic and diastolic blood pressure, antihypertensive medication use, questionnaire determined excessive sleepiness and Epworth Sleepiness Scale, and covariates.

RESULTS: The odds of hypertension at higher apnea hypopnea index categories were larger in participants identified as sleepy based on responses to a frequency of sleepiness question or the Epworth score. For example, for those with AHI > or =30 compared to AHI <1.5, the adjusted odds ratio for hypertension was 2.83 (1.33-6.04) among those reporting sleepiness > or =5 days per month, but only 1.22 (0.89-1.68) among those reporting less frequent daytime sleepiness. In adjusted logistic regression models, there was statistical evidence for effect modification by frequency of sleepiness (P = 0.033) of the association between apnea hypopnea index and hypertension. In adjusted models that included the Epworth score as a continuous variable, the interaction term fell slightly short of statistical significance (beta = 0.010, P = 0.07).

CONCLUSION: This study finds that the association of sleep disordered breathing with hypertension is stronger in individuals who report daytime sleepiness than in those who do not.

10aAged10aAntihypertensive Agents10aComorbidity10aCross-Sectional Studies10aDisorders of Excessive Somnolence10aFemale10aHealth Surveys10aHumans10aHypertension10aMale10aMiddle Aged10aOdds Ratio10aOxygen10aPolysomnography10aSleep Apnea, Obstructive10aUnited States1 aKapur, Vishesh, K1 aResnick, Helaine, E1 aGottlieb, Daniel, J1 aSleep Heart Health Study Group uhttps://chs-nhlbi.org/node/1051