Independent Association of Drug-Resistant Hypertension to Reduced Sleep Duration and Efficiency
Abstract
BACKGROUND: Experimentally induced sleep deprivation can raise blood pressure (BP) and worsen hypertension. We recently reported a significantly higher prevalence of obstructive sleep apnea (OSA) and reduced rapid eye movement (REM) sleep time in drug-resistant hypertensives compared to controlled hypertensives. The objective of this study was to test the hypothesis that short sleep duration is associated with resistant hypertension (RH) independently of OSA, which can itself disrupt and shorten sleep. METHODS: In a case-control study, overnight polysomnographic results of subjects with OSA and RH (n = 62) were compared to those with OSA of equal severity and either controlled hypertension (CH) (n = 49) or normotension (n = 40). RESULTS: Subjects with RH slept 33.8 min (P = 0.02) and 37.2 min (P = 0.02) less than those with CH and normotension, respectively. Consequently, sleep efficiency was reduced by 7.9% (P = 0.007) and 10.2% (P = 0.002), respectively. They also spent 9.7 min (P = 0.06) and 11.6 min (P = 0.04) less time in REM sleep compared to those with CH and normotension, respectively. Older age, greater body mass index (BMI) and greater apnea-hypopnea index (AHI) were also associated with shorter sleep time (P = 0.02, P = 0.001, and P = 0.03, respectively) and reduced sleep efficiency (P = 0.0003, P = 0.03, and P = 0.01, respectively). CONCLUSIONS: Our study demonstrates that, compared to subjects with CH or normotension, those with RH have shorter total and REM sleep times and lower sleep efficiency independently of OSA. These data suggest that reduced sleep time may contribute to the severity of hypertension.
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Individuals with obstructive sleep apnea or insomnia are at significantly greater risk for cardiovascular and cerebrovascular diseases and metabolic disorders.
“Population-based studies show that individuals with OSA or insomnia are at significantly greater risk for CVD and cerebrovascular diseases (eg, arrhythmias, atherosclerosis, coronary heart disease [CHD], heart failure, hypertension, and stroke) and metabolic disorders (eg, obesity, type 2 diabetes mellitus, and dyslipidemia).”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [8]
Other sleep abnormalities are manifest in resistant hypertension relative to those with controlled hypertension or normotensives, including shorter sleep duration, reduced sleep efficiency, and less rapid eye movement sleep.
“Other sleep abnormalities are also manifest in RH (relative to those with controlled hypertension or normotensives), including shorter sleep duration, reduced sleep efficiency, and less rapid eye movement sleep.50”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [50]
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- Authors
- Friedman, O., Bradley, T. D., Ruttanaumpawan, P., & Logan, A. G.
- Affiliations
- Mount Sinai Hospital (CA)
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-02-01
- Volume
- 23
- Issue
- 2
- Pages
- 174-179
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- OpenAlex
- W2125742630
- Cited by
- 67
- References
- 37
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2021: 1 · 2020: 3 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 7 · 2013: 7 · 2012: 9
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (MOP82731)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- resistant hypertension, sleep duration, sleep efficiency, obstructive sleep apnea, REM sleep, controlled hypertension, apnea-hypopnea index, body mass index, age, blood pressure
- MeSH terms
- Aged, Aging, Drug Resistance, Female, Humans, Hypertension, Male, Middle Aged, Sleep, Sleep Wake Disorders, Sleep Stages, Body Mass Index, Case-Control Studies, Polysomnography, Sleep Apnea, Obstructive
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