Article
Sleep irregularity and the association with hypertension and blood pressure levels: the ELSA-Brasil study
Registro en:
PARISE, Barbara K. et al. Sleep irregularity and the association with hypertension and blood pressure levels: the ELSA-Brasil study. Journal of Hypertension, v. 41, n. 4, p. 670-677, Apr. 2023.
0263-6352
10.1097/HJH.0000000000003392
Autor
Parise, Barbara K.
Santos, Ronaldo B.
Mesas, Arthur E.
Silva, Wagner A.
Giatti, Soraya
Aielo, Aline N.
Cunha, Lorenna F.
Souza, Silvana P.
Bortolotto, Luiz A.
Griep, Rosane H.
Lotufo, Paulo A.
Bensenor, Isabela M.
Drager, Luciano F.
Resumen
Methods: Adult participants from the ELSA-Brasil
performed a clinical evaluation including objective sleep
duration (actigraphy), insomnia, and a sleep study for
defining obstructive sleep apnoea (OSA). To quantify sleep
irregularity, we used two parameters obtained through
actigraphy: 7-day standard deviation (SD) of sleep duration
and 7-day SD of sleep-onset timing. A multivariate analysis
was used to determine the independent associations of
sleep irregularity with HTN and SBP/DBP values.
Results: We studied 1720 participants (age 49 8 years;
43.4% men) and 27% fulfilled the HTN diagnosis. After
adjustments for age, gender, race, BMI, excessive alcohol
consumption, physical activity intensity, urinary sodium
excretion, insomnia, objective sleep duration and OSA
(apnoea–hypopnoea index 15 events/h), we found that
the continuous analysis of 7-day SD of sleep duration was
modestly associated with prevalent HTN. However, 7-day
SD of sleep duration more than 90 min was independently
associated with SBP [b: 1.55; 95% confidence interval (CI)
0.23–2.88] and DBP (b: 1.07; 95% CI 0.12–2.01).
Stratification analysis excluding participants with OSA
revealed that a 7-day SD of sleep duration greater than
90 min was associated with a 48% higher chance of
having HTN (OR: 1.48; 95% CI: 1.05–2.07). No significant
associations were observed for the SD of sleep-onset
timing.
Conclusion: Objective measurement of sleep irregularity,
evaluated by SD of sleep duration for 1 week, was
associated with HTN and higher BP levels, especially in
participants without OSA. 2030