Sleep Patterns and Hypertension Using Actigraphy in the Hispanic Community Health Study/Study of Latinos

Chest. 2018 Jan;153(1):87-93. doi: 10.1016/j.chest.2017.09.028. Epub 2017 Sep 29.

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.

Keywords: Hispanic; hypertension; insomnia; sleep duration; sleep quality.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Actigraphy
  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Hispanic or Latino*
  • Humans
  • Hypertension / ethnology*
  • Male
  • Middle Aged
  • Prevalence
  • Sleep Apnea Syndromes / ethnology
  • Sleep Wake Disorders / ethnology*
  • United States / epidemiology
  • Young Adult