Insomnia with objective short sleep duration is associated with a high risk for hypertension.
OBJECTIVE
To examine the joint effect of insomnia and objective short sleep duration on hypertension risk.


METHODS
Representative cross-sectional study.


METHODS
Sleep laboratory.


METHODS
1,741 men and women randomly selected from central Pennsylvania.


METHODS
None.


METHODS
Insomnia was defined by a complaint of insomnia with a duration > or = 1 year, while poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into 3 categories: > or = 6 h sleep (top 50% of the sample); 5-6 h (approximately the third quartile of the sample); and < or = 5 h (approximately the bottom quartile of the sample). Hypertension was defined based either on blood pressure measures or treatment. We controlled for age, race, sex, body mass index, diabetes, smoking, alcohol use, depression, sleep disordered breathing (SDB), and sampling weight.


RESULTS
Compared to the normal sleeping and > 6 h sleep duration group, the highest risk of hypertension was in insomnia with < 5 h sleep duration group (OR [95% CI] 5.1 [2.2, 11.8]), and the second highest in insomnia who slept 5-6 hours (OR 3.5 [1.6, 7.9] P < 0.01). The risk for hypertension was significantly higher, but of lesser magnitude, in poor sleepers with short sleep duration.


CONCLUSIONS
Insomnia with short sleep duration is associated with increased risk of hypertension, to a degree comparable to that of other common sleep disorders, e.g., SDB. Objective sleep duration may predict the severity of chronic insomnia a prevalent condition whose medical impact has been apparently underestimated.
Sleep Research and Treatment Center Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA. avgontzas@psu.edu
Alexandros N
AN
Vgontzas
Duanping
D
Liao
Edward O
EO
Bixler
George P
GP
Chrousos
Antonio
A
Vela-Bueno
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D017286:Polysomnography; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology; D012892:Sleep Deprivation / Q000175:diagnosis / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013223:Statistics as Topic; D013997:Time Factors