Sunday, December 7, 2025

Sleep and hypertension (Discusssion)

Sleep and Hypertesion

Discussion

In the nationally representative survey, we observed that sleep factors—short sleep duration, self-reported trouble sleeping and sleep disorder—were each associated with an increased risk of hypertension. In addition, a positive dose-response relationship was identified between poor sleep pattern and a higher risk of hypertension.

Our findings are in agreement with those of previous studies. Short sleep duration was confirmed to be a risk factor for the incidence of hypertension [24,25],and

The risk of hypertension was reduced by 0.3207% for every 1 h of lengthening the sleep time [26].

In addition, longitudinal analyses of the

first NHANES survey (n = 4810) indicated that a short sleep duration led to an increased risk of developing or dying of hypertension [27].

A systematic review of 13 cross-sectional and longitudinal studies with a combination of 225,858 participants found a significant association between a short sleep duration and hypertension (RR, 1.23; 95% CI, 1.06 to 1.42; p = 0.005)

but a nonsignificant relationship between a long sleep duration and hypertension (RR, 1.02; 95% CI, 0.91–1.14; p = 0.732) [4].

Apart from sleep duration, other sleep factors,

such as sleep disorders and trouble sleeping, contribute to an increased risk of hypertension [28,29].

Despite the major role of the above sleep problems, the importance of overall sleep quality cannot be ignored.

A meta-analysis showed that poor sleep quality was significantly associated with a greater likelihood of hypertension (odds ratio, 1.48; p = 0.01) [29].

Additionally, a combined assessment of sleep behaviors suggested that the co-occurrence of insomnia and short sleep duration is associated with an increased risk of hypertension [30,31].

Consistent with this, we identified an association between overall sleep quality (defined as the sleep pattern) and an increased risk of hypertension.

Compaired with healthy sleep patterns participants with poor sleep patterns had a higher risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24, p < 0.001).

Several biological mechanisms have been proposed that relate sleep to the risk of hypertension.

Sleep disorders can affect central nervous system regulation [32], hemodynamics [33], ventilation function [34]

and biological rhythms [35,36], leading to physiological function alterations and pathological changes in blood pressure.

In addition, 16 cross-sectional studies have suggested that a short sleep duration, higher total energy intake and higher total fat intake are related to hypertension [37].

One clinical study found that a short sleep duration was associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite [38].

There is also evidence that short sleep can promote one’s appetite for salt and suppress the excretion of salt in the renal fluid [39].

A major strength of this study is the large sample size from NHANES.

Additionally, the complex nature of overall sleep was taken into consideration by integrating sleep quality and quantity (sleep duration, self-reported trouble sleeping and sleep disorder)

is into a single sleep measurement. There are some limitations to this study.

First, owing to the cross-sectional nature of the study, the results could not be used to define a causal link between sleep and hypertension. Second, the sleep-related data were collected from self-reports instead of objective measurements;

thus, there is a possibly of memory bias.

The data collected were limited regarding

sleep duration and referred only to weekdays; information on shift work and sleep duration from weekend was not provided.

Night shifts and early morning shifts may cause acute sleep loss,

and some studies support links between shift work, elevated blood pressure, and hypertension [40].

A recent study suggests that sleep debt, defined as a difference between weekday and weekend sleep deprivation of at least 2 h, was associated with poorer cardiovascular health in older females [41].

The forms of sleep disorders are many and varied, such as obstructive sleep apnea, insomnia, and delayed sleep phase disorder. Self-reported sleep disorders were not specifically classified, and the relationship between

certain types of sleep disorders and hypertension could not be measured.

Third, additional connections between sleep and hypertension were not considered. Although we controlled for a number of potential confounders, including demographics, health behaviors and clinical status, residual confounding factors might still be present.

Furthermore, the status of prescription medication use was not included in the analysis, as there were many missing values. Glucocorticoids can disrupt sleep and cause hypertension, and this was not accounted for in our study [42].

Ref

Int J Environ Res Public Health. 2021 Jul 25;18(15):7867. doi: 10.3390/ijerph18157867

Relationship between Sleep and Hypertension:

Findings from the NHANES (2007–2014)

Chunnan Li 1, Shaomei Shang 1,*

No comments:

Sunday, December 7, 2025

Sleep and hypertension (Discusssion)

Sleep and Hypertesion

Discussion

Our findings are in agreement with those of previous studies. Short sleep duration was confirmed to be a risk factor for the incidence of hypertension [24,25],and

The risk of hypertension was reduced by 0.3207% for every 1 h of lengthening the sleep time [26].

In addition, longitudinal analyses of the

first NHANES survey (n = 4810) indicated that a short sleep duration led to an increased risk of developing or dying of hypertension [27].

A systematic review of 13 cross-sectional and longitudinal studies with a combination of 225,858 participants found a significant association between a short sleep duration and hypertension (RR, 1.23; 95% CI, 1.06 to 1.42; p = 0.005)

but a nonsignificant relationship between a long sleep duration and hypertension (RR, 1.02; 95% CI, 0.91–1.14; p = 0.732) [4].

Apart from sleep duration, other sleep factors,

such as sleep disorders and trouble sleeping, contribute to an increased risk of hypertension [28,29].

Despite the major role of the above sleep problems, the importance of overall sleep quality cannot be ignored.

A meta-analysis showed that poor sleep quality was significantly associated with a greater likelihood of hypertension (odds ratio, 1.48; p = 0.01) [29].

Additionally, a combined assessment of sleep behaviors suggested that the co-occurrence of insomnia and short sleep duration is associated with an increased risk of hypertension [30,31].

Consistent with this, we identified an association between overall sleep quality (defined as the sleep pattern) and an increased risk of hypertension.

Compaired with healthy sleep patterns participants with poor sleep patterns had a higher risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24, p < 0.001).

Several biological mechanisms have been proposed that relate sleep to the risk of hypertension.

Sleep disorders can affect central nervous system regulation [32], hemodynamics [33], ventilation function [34]

and biological rhythms [35,36], leading to physiological function alterations and pathological changes in blood pressure.

In addition, 16 cross-sectional studies have suggested that a short sleep duration, higher total energy intake and higher total fat intake are related to hypertension [37].

One clinical study found that a short sleep duration was associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite [38].

There is also evidence that short sleep can promote one’s appetite for salt and suppress the excretion of salt in the renal fluid [39].

A major strength of this study is the large sample size from NHANES.

Additionally, the complex nature of overall sleep was taken into consideration by integrating sleep quality and quantity (sleep duration, self-reported trouble sleeping and sleep disorder)

is into a single sleep measurement. There are some limitations to this study.

First, owing to the cross-sectional nature of the study, the results could not be used to define a causal link between sleep and hypertension. Second, the sleep-related data were collected from self-reports instead of objective measurements;

thus, there is a possibly of memory bias.

The data collected were limited regarding

sleep duration and referred only to weekdays; information on shift work and sleep duration from weekend was not provided.

Night shifts and early morning shifts may cause acute sleep loss,

and some studies support links between shift work, elevated blood pressure, and hypertension [40].

A recent study suggests that sleep debt, defined as a difference between weekday and weekend sleep deprivation of at least 2 h, was associated with poorer cardiovascular health in older females [41].

The forms of sleep disorders are many and varied, such as obstructive sleep apnea, insomnia, and delayed sleep phase disorder. Self-reported sleep disorders were not specifically classified, and the relationship between

certain types of sleep disorders and hypertension could not be measured.

Third, additional connections between sleep and hypertension were not considered. Although we controlled for a number of potential confounders, including demographics, health behaviors and clinical status, residual confounding factors might still be present.

Furthermore, the status of prescription medication use was not included in the analysis, as there were many missing values. Glucocorticoids can disrupt sleep and cause hypertension, and this was not accounted for in our study [42].

Ref

Int J Environ Res Public Health. 2021 Jul 25;18(15):7867. doi: 10.3390/ijerph18157867

Relationship between Sleep and Hypertension:

Findings from the NHANES (2007–2014)

Chunnan Li 1, Shaomei Shang 1,*

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