title: Sleep to Lower Elevated Blood Pressure: A Randomized Controlled Trial (SLEPT).
abstract: BACKGROUND
  Impaired sleep quality is common and associated with an increased risk of cardiovascular disease (CVD), thought to be mediated through adverse effects on established vascular risk factors, particularly hypertension. We determined if a web-delivered sleep intervention (sleep-hygiene education, stimulus control, and cognitive behavioral therapy) reduces blood pressure compared to vascular risk factor education (standard care) alone.
  
  
  METHODS
  Phase II randomized, blinded, controlled trial of 134 participants without CVD with mild sleep impairment and blood pressure 130-160/<110 mm Hg. The primary outcome was the difference in the mean change in 24-hour ambulatory systolic blood pressure (SBP) over 8 weeks between intervention and control groups. Secondary outcomes included measures of sleep quality and psychosocial health, namely Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).
  
  
  RESULTS
  Participants in the sleep intervention group showed significantly greater improvements in sleep quality, including ISI [difference in mean improvement 2.8; 95% confidence interval (CI), 1.3-4.4], PSQI (1.1; 95% CI, 0.1-2.2), sleep condition indicator (0.8; 95% CI, 0.2-1.4), and psychosocial health, including BDI (2.0; 95% CI, 0.3-3.7) and BAI (1.4; 95% CI, 0.02-2.8). The mean improvement in 24-hour ambulatory SBP did not differ between the sleep intervention (0.9 mm Hg) and control (0.8 mm Hg) arms, (difference in mean improvement 0.1; 95% CI, -3.4 to 3.2).
  
  
  CONCLUSIONS
  A simple, low-cost, web-delivered sleep intervention is feasible and significantly improves sleep quality and measures of psychosocial health in individuals with mild sleep impairment but does not result in short-term improvements in blood pressure.
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.|Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.|3 Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Emer R
authors.initials: ER
authors.lastname: McGrath
authors.affiliation: Sleep & Circadian Neuroscience Institute, University of Oxford, Oxford, UK.|Big Health Ltd, London, UK.
authors.forename: Colin A
authors.initials: CA
authors.lastname: Espie
authors.affiliation: Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.
authors.forename: Alice
authors.initials: A
authors.lastname: Power
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Murphy
authors.affiliation: 8Croí, West of Ireland Cardiac Foundation, Galway, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Newell
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kelly
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.
authors.forename: Niamh
authors.initials: N
authors.lastname: Duffy
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gunning
authors.affiliation: Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.
authors.forename: Irene
authors.initials: I
authors.lastname: Gibson
authors.affiliation: Big Health Ltd, London, UK.|Department of Public Health and Epidemiology, University of Southampton, Southampton, UK.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bostock
authors.affiliation: HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: O'Donnell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001794:Blood Pressure; D003863:Depression / Q000523:psychology; D005260:Female; D006266:Health Education; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000523:psychology / Q000628:therapy*; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D012893:Sleep Wake Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: blood pressure; hypertension; primary prevention; risk factors; sleep.