4.5 Article

Longitudinal sleep characteristics and hypertension status: results from the Wisconsin Sleep Cohort Study

Journal

JOURNAL OF HYPERTENSION
Volume 39, Issue 4, Pages 683-691

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000002692

Keywords

hypertension; polysomnography; sleep; Wisconsin Sleep Cohort

Funding

  1. National Heart, Lung, and Blood Institute at the US National Institute of Health [R01HL62252]
  2. National Institute on Aging at the US National Institute of Health [R01AG036838, R01AG058680]
  3. National Center for Research Resources at the US National Institute of Health [UL1RR025011]
  4. Alzheimer's Association
  5. Barbara and Richard Csomay Center for Gerontological Excellence at the University of Iowa College of Nursing
  6. Aging, Mind, and Brain Initiative at the University of Iowa

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The study found that hypertension is associated with changes in sleep quality over time. Hypertensive individuals experienced a greater decline in total sleep time in rapid eye movement sleep and had less decline in N3 sleep compared to non-hypertensive individuals. They also had a higher probability of having difficulties falling asleep, as indicated by subjective insomnia complaints.
Aims: Sleep characteristics such as short sleep duration or sleep-disordered breathing are established predictors of hypertension. However, few studies have used in-lab polysomnography with a longitudinal design to measure how hypertension is associated with different sleep stages over time. The purpose of this study is to examine whether hypertension is associated with the longitudinal course of sleep quality over time. Methods: The current study evaluated data from the Wisconsin Sleep Cohort Study, which consists of 1525 adults in a community-based population of middle-aged to older adults followed for approximately 12-25 years. Sleep characteristics were objectively measured using polysomnography and subjectively assessed using a self-report questionnaire on insomnia complaints. We used linear mixed-effects regression models and cumulative logit models to assess whether the interaction of hypertension and time is associated with objective and subjective sleep. Results: We found people with hypertension exhibited a greater decline in total sleep time in rapid eye movement sleep (%) over time than those without hypertension (P < 0.05). Individuals with hypertension had less decline in % N3 sleep over time than those without hypertension (P < 0.05). Among the subjective insomnia complaints, our findings indicate hypertensive individuals have a higher probability of having higher levels of 'difficulties in falling asleep' compared with people without hypertension. Conclusion: These findings suggest that hypertension is associated with modified longitudinal changes of objective and subjective sleep characteristics.

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