Fragmented Sleep and the Prevalence of Hypertension in Middle-Aged and Older Individuals

Abstract

Objective: We aimed to investigate the association between fragmented sleep and the prevalence of hypertension in middle-aged and older individuals. Methods: This study included 5804 participants with an average age of 63.1±11.2 years from the Sleep Heart Health Study. Fragmented sleep parameters including arousal index in total sleep (ArI-Total), rapid eye movement sleep (ArI-REM), non-rapid eye movement sleep (ArI-NREM), fragmented sleep index (SFI), sleep efficiency (SE) and wake after sleep onset (WASO) were monitored using polysomnography. The information on hypertension, defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg or under antihypertensive treatment, was collected at baseline. We conducted multi-variable logistic regression to explore the cross-sectional association between fragmented sleep and the prevalence of hypertension. Results: After adjusting for potential confounders, fragmented sleep parameters (per 5-unit change) including SE (odds ratio [OR] 0.904; 95% confidence interval [CI] 0.877–0.932; P < 0.001), WASO (OR 1.019; 95% CI 1.012–1.027; P < 0.001), ArI-Total (OR, 1.036; 95% CI, 1.005– 1.068; P = 0.024), and ArI-NREM (OR 1.032; 95% CI 1.004–1.062; P = 0.027) were significantly associated with the prevalence of hypertension. In addition, ArI-Total, ArI-NREM, and ArI-REM were positively correlated with both systolic blood pressure and diastolic blood pressure. Conclusion: We found a high prevalence of hypertension among middle-aged and older individuals with fragmented sleep. The causal association between fragmented sleep and hypertension warrants further investigation.