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Cited by 947Sleep and related disordersObstructive Sleep Apnea ResearchBlood Pressure and Hypertension Studies

Association of usual sleep duration with hypertension: the Sleep Heart Health Study

Gottlieb, Daniel J., Redline, Susan, Nieto, F. Javier, Baldwin, Carol M., Newman, Anne B., Resnick, Helaine E., Punjabi, Naresh M.·2006·Sleep
DOI 10.1093/sleep/29.8.1009
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Abstract

STUDY OBJECTIVES: Limited experimental data suggest that sleep restriction acutely elevates blood pressure; however, little is known about the relationship between usual sleep duration and hypertension. This study assesses the relationship between usual sleep duration and hypertension in a community-based cohort. DESIGN: Cross-sectional observational study. SETTING: The Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing. PARTICIPANTS: Two thousand eight hundred thirteen men and 3097 women, aged 40 to 100 years. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Usual weekday and weekend sleep durations were obtained by questionnaire, and their weighted average were categorized as less than 6, 6 to less than 7, 7 to less than 8, 8 to less than 9, and 9 or more hours per night. Hypertension was defined as a systolic blood pressure of 140 mm Hg or greater, a diastolic blood pressure of 90 mm Hg or greater, or use of medication to treat hypertension. The relationship between sleep duration and hypertension was examined using categorical logistic regression with adjustment for age, sex, race, apnea-hypopnea index, and body mass index. Compared to subjects sleeping 7 to less than 8 hours per night, those sleeping less than 6 and between 6 and 7 hours per night had adjusted odds ratios for hypertension of 1.66 (95% confidence interval 1.35-2.04) and 1.19 (1.02-1.39), respectively, whereas those sleeping between 8 and 9 and 9 or more hours per night had adjusted odds ratios for hypertension of 1.19 (1.04-1.37) and 1.30 (1.04-1.62), respectively (p < .0001 for association of sleep duration with hypertension). These associations persisted when analyses were further adjusted for caffeine and alcohol consumption, current smoking, insomnia symptoms, depression symptoms, sleep efficiency, and prevalent diabetes mellitus or cardiovascular disease. CONCLUSIONS: Usual sleep duration above or below the median of 7 to less than 8 hours per night is associated with an increased prevalence of hypertension, particularly at the extreme of less than 6 hours per night.

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  • Some studies observed higher blood pressure among long sleepers.

    “Some of these studies also observed higher blood pressure among long sleepers [198, 203]”

    From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [198]

  • Self-reported short sleep and subjectively poor sleep quality have been associated with higher average blood pressure or higher prevalence of hypertension in cross-sectional studies.

    “Self-reported short sleep and subjectively poor sleep quality have been associated with higher average blood pressure or higher prevalence of hypertension in cross-sectional studies [197–203].”

    From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [198]

  • Sleep durations longer or shorter than 7-8 hours in a 24-hour period are associated with cardiovascular disease and diabetes risk factors, depression, automobile and workplace accidents, learning and memory problems, and excess mortality.

    “Sleep duration is associated with cardiovascular disease and diabetes risk factors, depression, automobile and workplace accidents, and prospective mortality.”

    From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [1]

  • Self-reported sleep duration reliably predicts prospective mortality and other health outcomes.

    “self-reported sleep duration reliably predicts prospective mortality and other health outcomes (1-7, 13-18).”

    From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [1]

  • Some epidemiological studies link shorter sleep durations to increased alcohol consumption and more frequent binge drinking, while others link longer sleep durations (usually > 9 h) to greater alcohol use.

    “Some epidemiological studies link shorter sleep durations to increased alcohol consumption and more frequent binge drinking (Krueger & Friedman, 2009), while others link longer sleep durations (usually > 9 h) to greater alcohol use (e.g., Gottlieb et al., 2006; Patel et al., 2004).”

    From Sleep and circadian contributions to adolescent alcohol use disorder (2015) · cites this paper as Gottlieb et al., 2006

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Research works printed but not linked: 2

  1. Lusardi P, Zoppi A, Preti P, Pesce RM, Piazza E, Fogari R. Effects of insufficient sleep on blood pressure in hypertensive patients: a 24-hour study. Am J Hypertens 1999;12:63-8.
  2. The fifth report of the Joint National Commission on Detection, Evaluation and Treatment of High Blood Pressure (JNC V). The Joint National Commission on Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med 1993;153:154-83.

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Authors
Gottlieb, D. J., Redline, S., Nieto, F. J., Baldwin, C. M., Newman, A. B., Resnick, H. E., & Punjabi, N. M.
Affiliations
  • Boston University (US)
  • Case Western Reserve University (US)
  • University of Wisconsin–Madison (US)
  • Arizona State University (US)
  • University of Pittsburgh (US)
  • MedStar Health Research Institute (US)
  • Johns Hopkins University (US)
Corresponding author
Gottlieb, Daniel J.
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2006-08
Volume
29
Issue
8
Pages
1009-1014
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/29.8.1009
OpenAlex
W124262366
Cited by
947
References
27
Citations by year
2026: 14 · 2025: 31 · 2024: 29 · 2023: 43 · 2022: 69 · 2021: 37 · 2020: 58 · 2019: 61 · 2018: 43 · 2017: 60 · 2016: 54 · 2015: 56 · 2014: 58 · 2013: 71 · 2012: 48
FWCI
44.99
Type
journal article
Language
en
Open access
closed
Locations
  • SLEEP (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Minnesota (U01HL64360, U01HL53941, U01HL53940, U01HL539 31, U01HL53938, U01HL53934, U01HL53937, U01HL63463, U01HL53916)
  • University of Washington (U01HL53941, U01HL53938, U01HL53940, U01HL63463, U01HL53916, U01HL53931, U01HL53934)
  • Johns Hopkins University (U01-HL53938, U01HL53937, U01HL53916, U01HL63463, U01HL53941, U01HL64360, U01HL53931, U01HL53940, U01HL53934)
  • Case Western Reserve University (U01HL63463, U01HL53934, U01HL53931, U01HL53916, U01HL63429, U01HL53938, U01HL53940, U01HL53941)
  • Strong
  • York University
  • National Institutes of Health (5u01hl053940-05, 5u01hl053934-14)
  • University of California, Davis (U01HL53941, U01HL53931, U01HL53940, U01HL53938, U01HL53916, U01HL63463, U01HL53934)
  • National Heart, Lung, and Blood Institute (U01 HL 53940, U01HL53938, U01HL053941, U01HL053938, U01 HL53934, U01HL053937, U01 HL 53941, U01 HL53916, U01HL053931, U01 HL 63429, HL53938-07S1, U01HL064360, U01HL053916, U01 HL53931, U01HL063463, U01HL64360, U01HL063429, U01HL63463, U01-HL53937)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
sleep duration, hypertension, short sleep duration, long sleep, blood pressure, Sleep Heart Health Study, sleep-disordered breathing, apnea-hypopnea index, cardiovascular risk
MeSH terms
Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Health Surveys, Humans, Hypertension, Male, Middle Aged, Prospective Studies, Sleep, Sleep Deprivation, Statistics as Topic, Cohort Studies, Comorbidity, Body Mass Index, Odds Ratio, Sleep Apnea, Obstructive

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