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SLEEP - Article Abstract

Volume 32, Issue 4, Pages 491-497

Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension

Alexandros N. Vgontzas, MD 1; Duanping Liao, PhD 2; Edward O. Bixler, PhD 1; George P. Chrousos, MD 3; Antonio Vela-Bueno, MD 4

1 Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA; 2Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA; 3First Department of Pediatrics and Unit on Endocrinology, Metabolism and Diabetes, University of Athens, Athens, Greece; 4Department of Psychiatry, School of Medicine, Autonomous University, Madrid, Spain

Study Objectives: To examine the joint effect of insomnia and objective short sleep duration on hypertension risk.

Design: Representativecross-sectional study.

Setting: Sleep laboratory.

Participants: 1,741 men and womenrandomly selectedfrom central Pennsylvania.

Interventions: None.

Measurements: Insomnia was defined by a co mplaint of insomnia with a duration ≥ 1 year, while poor sleep was defined as a co mplaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into 3 categories: ≥ 6 h sleep (top 50% of the sample); 5-6 h (approximately the third quartile of the sample); and ≤ 5 h (approximately the bottom quartile of the sample). Hypertension was defined based either on blood pressure measures or treatment. We co ntrolled for age, race, sex, body mass index, diabetes, smoking, al co hol use, depression, sleep disordered breathing (SDB), and sampling weight.

Results: Compared to the normal sleeping and > 6 h sleep duration group, the highest risk of hypertension was in insomnia with < 5 h sleep duration group (OR [95% CI] 5.1 [2.2, 11.8]), and the se co nd highest in insomnia who slept 5-6 hours (OR 3.5 [1.6, 7.9] P < 0.01). The risk for hypertension was significantly higher, but of lesser magnitude, in poor sleepers with short sleep duration.

Conclusions: Insomnia with short sleep duration is associated with increased risk of hypertension, to a degree co mparable to that of other co mmon sleep disorders, e.g., SDB. Objective sleep duration may predict the severity of chronic insomnia a prevalent co ndition whose medical impact has been apparently underestimated.

Keywords: Insomnia, objective sleep duration, hypertension

Citation: Vgontzas AN; Liao D; Bixler EO; Chrousos GP; Vela-Bueno A. Insomnia with objective short sleep duration is associated with a high risk for hypertension. SLEEP 2009;32(4):491-497.