title: Sleep quality and elevated blood pressure in adolescents.
abstract: BACKGROUND
  We assessed whether insufficient sleep is associated with prehypertension in healthy adolescents.
  
  
  RESULTS
  We undertook a cross-sectional analysis of 238 adolescents, all without sleep apnea or severe comorbidities. Participants underwent multiple-day wrist actigraphy at home to provide objective estimates of sleep patterns. In a clinical research facility, overnight polysomnography, anthropometry, and 9 blood pressure measurements over 2 days were made. Exposures were actigraphy-defined low weekday sleep efficiency, an objective measure of sleep quality (low sleep efficiency < or =85%), and short sleep duration (< or =6.5 hours). The main outcome was prehypertension (> or =90th percentile for age, sex, and height), with systolic and diastolic blood pressures as continuous measures as secondary outcomes. Prehypertension, low sleep efficiency, and short sleep duration occurred in 14%, 26%, and 11% of the sample, respectively. In unadjusted analyses, the odds of prehypertension increased 4.5-fold (95% CI, 2.1 to 9.7) in adolescents with low sleep efficiency and 2.8-fold (95% CI, 1.1 to 7.3) in those with short sleep. In analyses adjusted for sex, body mass index percentile, and socioeconomic status, the odds of prehypertension increased 3.5-fold (95% CI, 1.5. 8.0) for low sleep efficiency and 2.5-fold (95% CI, 0.9 to 6.9) for short sleep. Adjusted analyses showed that adolescents with low sleep efficiency had on average a 4.0+/-1.2-mm Hg higher systolic blood pressure than other children (P<0.01).
  
  
  CONCLUSIONS
  Poor sleep quality is associated with prehypertension in healthy adolescents. Associations are not explained by socioeconomic status, obesity, sleep apnea, or known comorbidities, suggesting that inadequate sleep quality is associated with elevated blood pressure.
authors: Case Western Reserve University, Cleveland, OH 44106-6003, USA.
authors: Sogol
authors: S
authors: Javaheri
authors: Amy
authors: A
authors: Storfer-Isser
authors: Carol L
authors: CL
authors: Rosen
authors: Susan
authors: S
authors: Redline
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D012890:Sleep; D012892:Sleep Deprivation / Q000150:complications / Q000503:physiopathology*