Insomnia With Objective Short Sleep Duration and Incident Hypertension The Penn State Cohort

被引:350
作者
Fernandez-Mendoza, Julio [1 ]
Vgontzas, Alexandros N. [1 ]
Liao, Duanping [2 ]
Shaffer, Michele L. [2 ]
Vela-Bueno, Antonio [3 ]
Basta, Maria [4 ]
Bixler, Edward O. [1 ]
机构
[1] Penn State Univ, Coll Med, Sleep Res & Treatment Ctr, Dept Psychiat, Hershey, PA 17033 USA
[2] Penn State Univ, Coll Med, Dept Publ Hlth Sci, Hershey, PA 17033 USA
[3] Autonomous Univ Madrid, Sch Med, Dept Psychiat, E-28049 Madrid, Spain
[4] Univ Crete, Sch Med, Dept Psychiat, Iraklion, Greece
基金
美国国家卫生研究院;
关键词
insomnia; polysomnography; hypertension; incidence; MATCHED NORMAL SLEEPERS; HEART-RATE-VARIABILITY; GENERAL-POPULATION; RISK; ASSOCIATION; PREVALENCE; APNEA; MEN;
D O I
10.1161/HYPERTENSIONAHA.112.193268
中图分类号
R6 [外科学];
学科分类号
100210 [外科学];
摘要
Insomnia with objective short sleep duration appears to be a biologically more severe phenotype of the disorder. No longitudinal study to date has examined the association of this type of insomnia with incident hypertension using polysomnography. From a random, general population sample of 1741 adults of the Penn State Cohort, 1395 were followed-up after 7.5 years, and 786 did not have hypertension at baseline. Hypertension was determined by a self-report of receiving treatment for high blood pressure. Chronic insomnia was defined as a complaint of insomnia lasting >= 1 year, whereas poor sleep was defined as moderate-to-severe sleep difficulties. All of the subjects underwent 8-hour polysomnography. Sleep-disordered breathing (SDB) was defined as an obstructive apnea/hypopnea index >= 5. We used the median polysomnographic percentage of sleep time to define short sleep duration (ie, <6 hours). We controlled for sex, race, age, caffeine, cigarettes and alcohol consumption, depression, sleep-disordered breathing, diabetes mellitus, obesity, and blood pressure in our analyses. Compared with normal sleepers who slept >= 6 hours, the highest risk for incident hypertension was in chronic insomniacs with short sleep duration (odds ratio, 3.8 [95% CI, 1.6-9.0]). The risk for incident hypertension in poor sleepers with short sleep duration was significantly increased but became marginally significant after controlling for obesity (odds ratio, 1.6 [95% CI, 0.9-2.8]). Chronic insomnia with short sleep duration is associated with an increased risk for incident hypertension in a degree comparable to sleep-disordered breathing. Objective short sleep duration in insomnia may serve as a useful predictor of the biological severity of the disorder. (Hypertension. 2012; 60: 929-935.) center dot Online Data Supplement
引用
收藏
页码:929 / +
页数:17
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