title: Sleep and risk for high blood pressure and hypertension in midlife women: the SWAN (Study of Women's Health Across the Nation) Sleep Study.
abstract: OBJECTIVE
  Inadequate self-reported sleep is related to high blood pressure (BP). Our study investigated cross-sectional and longitudinal relationships between poor sleep measured by in-home polysomnography (PSG) and BP.
  
  
  METHODS
  Midlife participants (132 black, 164 white, and 59 Chinese) were from the SWAN (Study of Women's Health Across the Nation) ancillary sleep study. In-home PSG measured sleep apnea, duration, efficiency, and electroencephalogram (EEG) total delta and beta power during nonrapid eye movement (NREM) sleep. Women subsequently were followed annually for 4.5 (1-7)years for BP and hypertensive status (>140/90 mmHg or use of antihypertensive medication). Covariates were age, race, site, and educational attainment, with time-covariates of BP medications, body mass index, diabetes mellitus (DM), cigarette smoking, and menopausal status.
  
  
  RESULTS
  Sleep duration and efficiency were unrelated to BP cross-sectionally or longitudinally in multivariate models. Women with higher total beta power were more likely to be hypertensive at the time of the sleep study; women with lower total delta power were more likely to show increases in diastolic BP (DBP) and to be at risk for incident hypertension across follow-up.
  
  
  CONCLUSIONS
  Low NREM delta power may be a risk factor for future hypertension. Quantitative EEG measures are worthy of future investigations of hypertension risk.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, United States; Department of Epidemiology, University of Pittsburgh, PA, United States; Department of Psychology, University of Pittsburgh, PA, United States. Electronic address: matthewska@upmc.edu.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, PA, United States.
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States; Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, United States; Department of Epidemiology, University of Pittsburgh, PA, United States.
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, United States.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Owens
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, United States.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Buysse
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, United States; Department of Psychology, University of Pittsburgh, PA, United States.
authors.forename: Martica H
authors.initials: MH
authors.lastname: Hall
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology
keywords: Epidemiology; Hypertension; Polysomnography; Sleep duration; Sleep stages; Women