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Insomnia symptoms, frequency not linked to hypertension
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In a new study, researchers reported no significant association between hypertension and the frequency and symptoms of insomnia.
“There is growing concern among patients and health care providers regarding the potential medical sequelae of insomnia, especially on the cardiovascular system. If a causal link between insomnia and hypertension exists, this would have several important implications for patients and their medical care,” Nicholas T. Vozoris, MHSc, MD, from the respirology division at St. Michael’s Hospital at University of Toronto, wrote.
The population-based, cross-sectional study included data on 12,643 participants who responded to questions about sleep quality as part of the National Health and Nutrition Examination Surveys (2005-2008). Participants provided information on the frequency of self-reported symptoms of insomnia within the prior month, as well as the duration of sleep time.
Frequency of self-reported insomnia symptoms was categorized as 0, 1 to 4, 5 to 15 or 16 to 30 episodes. Vozoris also evaluated history of hypertension, use of antihypertensive medications and objective measurements of systolic and diastolic BP.
Without including a short sleep duration (<6 hours) in the definition of insomnia, 78.6% of participants indicated insomnia symptoms. Such symptoms included difficulty falling asleep, prolonged nocturnal awakening or undesired early morning awakening. Including short sleep duration in the definition reduced the number of patients experiencing insomnia symptoms to 11.4%.
Unadjusted analysis revealed a significant increase in the risk for hypertension and use of antihypertensive medications with increasing frequency of insomnia symptoms, both with and without the inclusion of sleep duration in the definition. However, all associations were attenuated or failed to achieve statistical significance after adjustment for confounders.
No association was observed between insomnia and objective measurements of systolic or diastolic BP, regardless of symptom frequency. Vozoris noted a significant risk increase for diastolic hypertension among participants who indicated 16 to 30 episodes of insomnia as well as sedative use, but only when short sleep duration was not included in the definition (adjusted OR=9.96; 95% CI, 1.01-98.16 without inclusion; adjusted OR=1.57; 95% CI, 0.14-17.85 with inclusion).
“These results have important implications related to screening and management of patients with insomnia symptoms,” Vozoris wrote. “Based on these results, physicians should be discouraged from prescribing sedative pharmacotherapy, which is associated with increased morbidity and mortality, for insomnia from a possible cardioprotective perspective.”
Disclosure: Vozoris reports receiving one-time lecture fees from Centric Health.
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