Acute and chronic effects of sleep duration on blood pressure

Abstract

Objective: To evaluate the association between ambulatory blood pressure (ABP) and sleep duration as measured by 7-day sleep diary and nocturnal polysomnography in normal-weight adolescents without significant obstructive sleep apnea.

Methods: Subjects aged 10 to 17.9 years with an obstructive apnea hypopnea index <5 underwent polysomnography for 9.5 hours and 24-hour ABP monitoring commencing at noon on the same day. ABP was divided into prepolysomnography, in bed during polysomnography, and postpolysomnography periods for separate analyses. Sleep duration (SpD7) was obtained from a 7-day sleep diary, reflecting the sleep pattern in the week before admission. Total sleep time (TST) and sleep efficiency (SpE) were obtained from polysomnography.

Results: A total of 143 adolescents participated. SpD7 was inversely associated with systolic blood pressure (SBP) in prepolysomnography, in-bed, and postpolysomnography periods (all β = -2 mm Hg) and with diastolic blood pressure (DBP) in prepolysomnography and in-bed periods (all β = -1 mm Hg). TST was inversely associated with SBP in the postpolysomnography period (β = -1.5 mm Hg). SpE was inversely associated with SBP in in-bed period (β = -0.1 mm Hg) and with DBP in in-bed (β = -0.1 mm Hg) and postpolysomnography (β = -0.2 mm Hg) periods. Neither TST nor SpE was associated with SBP and DBP in prepolysomnography period.

Conclusions: Short sleep duration as reflected by 7-day sleep diary was associated with higher blood pressure in normal-weight adolescents. Occasional adequate sleep may partially ameliorate the risk of high blood pressure but may not completely reverse the effect of long-term sleep insufficiency.

Keywords: adolescents; ambulatory blood pressure monitoring; obesity; obstructive sleep apnea; short sleep.