Acute and Chronic Effects of Sleep Duration on Blood Pressure

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Inconsistent results have been reported on the association between sleep duration and blood pressure (BP) in children, likely as a result of inadequate adjustment for confounders and the use of different time frames in assessing sleep duration.WHAT THIS STUDY ADDS: Short sleep duration and poor sleep quality are associated with higher BP in normal-weight adolescents. One night of adequate sleep may partially ameliorate the risk of high BP but cannot completely reverse the effect of chronic sleep insufficiency. abstract OBJECTIVE: To evaluate the association between ambulatory blood pressure (ABP) and sleep duration as measured by 7-day sleep diary and nocturnal polysomnography in normal-weight adolescents without significant obstructive sleep apnea. METHODS:Subjects aged 10 to 17.9 years with an obstructive apnea hypopnea index ,5 underwent polysomnography for 9.5 hours and 24-hour ABP monitoring commencing at noon on the same day. ABP was divided into prepolysomnography, in bed during polysomnography, and postpolysomnography periods for separate analyses. Sleep duration (SpD 7 ) was obtained from a 7-day sleep diary, reflecting the sleep pattern in the week before admission. Total sleep time (TST) and sleep efficiency (SpE) were obtained from polysomnography. RESULTS:A total of 143 adolescents participated. SpD 7 was inversely associated with systolic blood pressure (SBP) in prepolysomnography, in-bed, and postpolysomnography periods (all b = 22 mm Hg) and with diastolic blood pressure (DBP) in prepolysomnography and in-bed periods (all b = 21 mm Hg). TST was inversely associated with SBP in the postpolysomnography period (b = 21.5 mm Hg). SpE was inversely associated with SBP in in-bed period (b = 20.1 mm Hg) and with DBP in in-bed (b = 20.1 mm Hg) and postpolysomnography (b = 20.2 mm Hg) periods. Neither TST nor SpE was associated with SBP and DBP in prepolysomnography period.CONCLUSIONS: Short sleep duration as reflected by 7-day sleep diary was associated with higher blood pressure in normal-weight adolescents. Occasional adequate sleep may partially ameliorate the risk of high blood pressure but may not completely reverse the effect of long-term sleep insufficiency. Pediatrics 2014;133:e64-e72

Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review

“…Three of these reported that decreased sleep duration or decreased sleep continuity was associated with elevated BP for a portion or all of the ambulatory monitoring period. 43;45;46 In contrast, Martikainen et al reported that neither self-reported sleep disturbance nor actigraphy-assessed sleep characteristics were associated with ambulatory BP in a sample of Finnish 8-year-olds. 50;55 Thus, it is possible that multiple measurements of BP collected over an extended time period may reveal more robust associations with sleep than a limited number of clinic assessments.…”

Later School Start Time: The Impact of Sleep on Academic Performance and Health in the Adolescent Population

“…For example, an increase in body weight [50], a higher risk of obesity [51][52][53], and a reduced physical activity [54] in association with low sleep were observed in the teen population. Furthermore, sleep loss in adolescents is likely to lead to increases in blood pressure [55,56] and high cardiometabolic risk [57]. Poor sleep in adolescents is also positively associated with other somatic outcomes, such as headache [58], persistent fatigue [59], and lower back, neck, and abdominal pain [60].…”

A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

“…4,5 Sleep deprivation is associated with daytime sleepiness, attention impairment, and poor academic performance, [6][7][8][9] and it is also empirically linked to heightened risk of mood disorders, obesity, hyperlipidemia, and high blood pressure in young students. [10][11][12][13][14] An interactive network of internal and external factors contributes to insufficient sleep in adolescents. Although adolescents experience a marked change in circadian timing with a consequent delay of bedtime, 15 school start time, academic work, extracurricular activities, media usage, and parental sleep pattern can all impede their sleep-wake schedule.…”