Insomnia with objective, but not subjective, short sleep duration is associated with increased risk of incident hypertension: the Sleep Heart Health Study
In this large prospective cohort study, we found that ISSD, defined based on objective but not subjective sleep duration, is associated with increased risk of incident hypertension at a median follow-up duration of 5.1 years. In contrast, INSD, either defined based on objective or subjective sleep duration, is not associated with increased hypertension risk. These data further support that ISSD is a phenotype of insomnia disorder associated with new onset hypertension in adult women and men and, thus,
more severe from a cardiometabolic standpoint.
Our study is consistent with the study by Fernandez-Mendoza et al in the Penn State Adult Cohort who first reported that ISSD, defined based on 1 night of in-lab PSG, was associated with increased risk for incident hypertension, defined based on self-reports of a physician diagnosis of hypertension at follow-up. The current study had a larger sample size and used a definition of incident hypertension by including 3 consecutive manually obtained measures of BP and/or use of antihypertensive medications to define incident hypertension, and the findings were consistent with Fernandez-Mendoza et al Our study is also consistent with a prior study by Bertisch et a in the SHHS who showed that ISSD was associated with increased risk of cardiovascular diseases. Notably, our study failed to show an association between ISSD defined based on self-reported sleep duration and incident hypertension, consistent with a cross-sectional previous study in a clinical sample. The consistent findings based on 2 large general population cohort studies, ie, the PASC and the SHHS, on the association of ISSD with cardiovascular morbidity further support the concept that it is a more severe, objectively defined phenotype associated with increased risk of cardiometabolic morbidity and mortality.
Comments