title: Association between sleep and blood pressure in midlife: the CARDIA sleep study.
abstract: BACKGROUND
  Epidemiological studies have reported an association between self-reported short sleep duration and high blood pressure (BP). Our objective was to examine both cross-sectional and longitudinal associations between objectively measured sleep and BP.
  
  
  METHODS
  This study is ancillary to the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study. Blood pressure was measured in 2000 and 2001 and in 2005 and 2006. Sleep was measured twice using wrist actigraphy for 3 consecutive days between 2003 and 2005. Sleep duration and sleep maintenance (a component of sleep quality) were calculated. Analyses included 578 African Americans and whites aged 33 to 45 years at baseline. Outcome measures were systolic BP (SBP) and diastolic BP (DBP) levels, 5-year change in BP, and incident hypertension.
  
  
  RESULTS
  After we excluded the patients who were taking antihypertensive medications and adjusted for age, race, and sex, shorter sleep duration and lower sleep maintenance predicted significantly higher SBP and DBP levels cross-sectionally as well as more adverse changes in SBP and DBP levels over 5 years (all P < .05). Short sleep duration also predicted significantly increased odds of incident hypertension (odds ratio, 1.37; 95% confidence interval, 1.05-1.78). Adjustment for 16 additional covariates, including snoring and daytime sleepiness, slightly attenuated the associations between sleep and BP. Sleep duration appeared to mediate the difference between African Americans and whites in DBP change over time (P = .02).
  
  
  CONCLUSIONS
  Reduced sleep duration and consolidation predicted higher BP levels and adverse changes in BP, suggesting the need for studies to investigate whether interventions to optimize sleep may reduce BP.
authors.affiliation: Department of Health Studies, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637, USA. kknutson@health.bsd.uchicago.edu
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Knutson
authors.forename: Eve
authors.initials: E
authors.lastname: Van Cauter
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Rathouz
authors.forename: Lijing L
authors.initials: LL
authors.lastname: Yan
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Hulley
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Diane S
authors.initials: DS
authors.lastname: Lauderdale
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology*