Insomnia With Objective Short Sleep Duration and Incident Hypertension: The Penn State Cohort
Open accessAbstract
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.
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The odds of hypertension or type-2 diabetes in individuals who reported insomnia but slept objectively >6 hours were not significantly increased.
“while the odds of hypertension or T2D in individuals who reported insomnia but slept objectively > 6 hours were not significantly increased (e.g., OR = 1.3 and 0.85).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [180]
Recent work from the Penn State Adult Cohort has shown a synergistic effect between insomnia and PSG-measured short sleep duration (<6 hours) on the risk for hypertension and type-2 diabetes even after controlling for multiple confounders, including sleep-disordered breathing.
“Based on the physiologic mechanisms reviewed above, recent work from the Penn State Adult Cohort has shown a synergistic effect between insomnia and PSG-measured short sleep duration (i.e., < 6 hours) on the risk for hypertension and T2D even after controlling for multiple confounders, including SDB(178-180).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [178]
Recent work from the Penn State Adult Cohort has shown a synergistic effect between insomnia and PSG-measured short sleep duration (<6 hours) on the risk for hypertension and type-2 diabetes even after controlling for multiple confounders, including sleep-disordered breathing.
“Based on the physiologic mechanisms reviewed above, recent work from the Penn State Adult Cohort has shown a synergistic effect between insomnia and PSG-measured short sleep duration (i.e., < 6 hours) on the risk for hypertension and T2D even after controlling for multiple confounders, including SDB(178-180).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [180]
The odds of hypertension in individuals with insomnia who slept <6 hours were 3.5- to 5.1-fold cross-sectionally and 3.8-fold longitudinally.
“and the odds of hypertension were 3.5- to 5.1-fold cross-sectionally71 and 3.8-fold longitudinally”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [178]
The odds of hypertension in individuals with insomnia who slept <6 hours were 3.5- to 5.1-fold cross-sectionally and 3.8-fold longitudinally.
“and the odds of hypertension were 3.5- to 5.1-fold cross-sectionally71 and 3.8-fold longitudinally”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [180]
The odds of hypertension or type-2 diabetes in individuals who reported insomnia but slept objectively >6 hours were not significantly increased.
“while the odds of hypertension or T2D in individuals who reported insomnia but slept objectively > 6 hours were not significantly increased (e.g., OR = 1.3 and 0.85).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [178]
The odds of type-2 diabetes in individuals with insomnia who slept <6 hours were 2.1- to 3.0-fold cross-sectionally.
“Specifically, the odds of T2D in individuals with insomnia who slept < 6 hours were 2.1- to 3.0-fold cross-sectionally”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [180]
The odds of type-2 diabetes in individuals with insomnia who slept <6 hours were 2.1- to 3.0-fold cross-sectionally.
“Specifically, the odds of T2D in individuals with insomnia who slept < 6 hours were 2.1- to 3.0-fold cross-sectionally”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [178]
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- Authors
- Fernandez-Mendoza, J., Vgontzas, A. N., Liao, D., Shaffer, M. L., Vela-Bueno, A., Basta, M., & Bixler, E. O.
- Affiliations
- From the Sleep Research and Treatment Center, Department of Psychiatry (J.F.-M., A.N.V., E.O.B.), Department of Public Health Sciences (D.L., M.L.S.), Pennsylvania State University College of Medicine, Hershey, PA; Department of Psychiatry (A.V.-B.), School of Medicine, Autonomous University, Madrid, Spain; Department of Psychiatry (M.B.), School of Medicine, University of Crete, Crete, Greece.
- Pennsylvania State University (US)
- Venue
- Hypertension
- Published
- 2012-10
- Volume
- 60
- Issue
- 4
- Pages
- 929-935
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC3679545
- OpenAlex
- W2141289928
- Cited by
- 425
- References
- 39
- Citations by year
- 2026: 18 · 2025: 27 · 2024: 22 · 2023: 31 · 2022: 39 · 2021: 25 · 2020: 38 · 2019: 40 · 2018: 40 · 2017: 32 · 2016: 35 · 2015: 30 · 2014: 21 · 2013: 24 · 2012: 2
- FWCI
- 33.00
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pennsylvania State University
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL040916, R01HL064415, R01HL051931)
- 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
- insomnia, short sleep duration, hypertension incidence, chronic insomnia, poor sleep quality, sleep-disordered breathing, obstructive sleep apnea, polysomnography, obesity
- MeSH terms
- Adult, Aged, Female, Follow-Up Studies, Health Surveys, Humans, Hypertension, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Surveys and Questionnaires, Risk, Sleep, Sleep Apnea Syndromes, Incidence, Polysomnography
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