Associations of Sleep Duration and Disturbances With Hypertension in Metropolitan Cities of Delhi, Chennai, and Karachi in South Asia: Cross-Sectional Analysis of the CARRS Study

Abstract

Abstract:Objectives: Sleep duration and disturbances may be risk factors for hypertension. Despite the high burden of hypertension in South Asia, little is known about this relationship in this region.Methods: We analyzed population-level cross-sectional data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) study that recruited representative samples of adults ≥ 20 years from three cities-Delhi, Chennai (India) and Karachi (Pakistan) during 2010-11. We defined hypertension as self-reported treatment or measured blood pressure (BP) ≥140/90mmHg. Data on usual duration of sleep, insomnia and snoring were collected using "The Sleep Habits Questionnaire" and excessive daytime sleepiness (EDS) using Epworth Sleepiness Score. Logistic and linear regression were done with hypertension and BP as outcome variables, respectively. Age, sex, education, wealth index, family history, and body mass index (BMI) were included as covariates. We used multiple imputation to account for missing variables. Conclusion: Self-reported snoring and insomnia were associated with hypertension in South Asia. This relationship needs further exploration through robust longitudinal studies in this region.

Association between sleep duration and hypertension of migrant workers in China: a national cross-sectional surveillance study

“…A Korean national cross-sectional study showed that short sleep duration (≤5 hours) was independently associated with hypertension in young and middle-aged Korean adults but there was no association in those aged ≥65 years 52. A cross-sectional analysis of the CARRS Study in Delhi, Chennai and Karachi in South Asia showed that there was no association between either short or long duration of sleep with hypertension after adjusting for other hypertension risk factors 53. A study conducted in Japanese male workers showed that sleep duration of 6 hours or more did not relate to the occurrence of any components of the metabolic syndrome, including hypertension 54.…”

Cardiovascular autonomic dysfunction in insomnia patients with objective short sleep duration

“…The non‐significant findings may be explained by the incongruity of comparing subjectively‐ and objectively‐measured variables. Indeed, similar non‐significant results have been documented when sleep duration was based on self‐reports and outcomes were based on objective indices (Shivashankar et al., ). Conversely, when sleep duration and health outcomes were both subjective, significant associations were observed (Kalmbach et al., ).…”

Insomnia and hypertension: A misty landscape

“…More importantly, available studies used different definition of hypertension, and methodologies for BP measurements (home, office, and rarely ambulatory BP values). Table summarizes the data from large cross‐sectional and longitudinal studies, published over the last 2‐years, assessing the risk of hypertension in patients with insomnia …”

“…5,6 With regard to hypertension, few data suggest that both Table 1 summarizes the data from large cross-sectional and longitudinal studies, published over the last 2-years, assessing the risk of hypertension in patients with insomnia. [10][11][12][13][14][15][16] A recently published systematic-review pooled data from 64 clinical studies with diverse designs, including more than 740 000 adults (46.4% male) with insomnia to investigate the relationship between insomnia and hypertension. 17 It was found that when insomnia is frequent, chronic, and accompanied with short sleep or objective indices of arousal, there is a robust link with hypertension.…”