Sleep duration a predictor of high blood pressure in teens regardless of insomnia
Key takeaways:
- Short average sleep duration plus self-reported insomnia was linked to hypertension among adolescents.
- Complaints of insomnia were not linked to elevated BP among teens with adequate sleep.
Short sleep duration, with and without self-reported insomnia, was predictive of elevated blood pressure and hypertension among adolescents, a speaker reported.
At the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions, Julio Fernandez-Mendoza, PhD, CBSM, DBSM, Edward O. Bixler, PhD, Professor of Psychiatry and Behavioral Health, professor of public health sciences and neural and behavioral sciences at Pennsylvania State University College of Medicine, presented a study demonstrating a significant association between objectively measured average sleep duration and likelihood of high BP among adolescents.
“Most evidence on the association of insomnia and short sleep with elevated blood pressure and hypertension comes from studies in middle-aged adults, so there was a gap in understanding this relationship in youth,” Fernandez-Mendoza, who is also director of behavioral sleep medicine at the Penn State Health Sleep Research and Treatment Center, told Healio.
To better understand the relationship between insomnia, sleep duration and elevated BP, Fernandez-Mendoza and colleagues conducted 9-hour polysomnography and physical examinations in a cohort of 421 adolescents from the Penn State Child Cohort, a randomly selected population-based sample (mean age, 16.5 years; 54% male).
Insomnia, sleep duration and BP
Insomnia was defined using self-report and short sleep duration — less than 7.7 hours — using the median polysomnography-measured sleep time.
Elevated BP was defined as average BP of 120 mm Hg or higher/80 mm Hg or lower, whereas hypertension was defined as average BP of 140/90 mm Hg or higher.
Compared with a reference group of adolescents without self-reported insomnia who got sufficient sleep, those with self-reported insomnia and objectively short duration sleep had approximately fivefold the odds of having hypertension (95% CI, 1.1-23; P = .041).
Adolescents without self-reported insomnia but objectively short duration sleep had nearly threefold the odds of having elevated BP compared with the reference group (95% CI, 1.5-4.8; P = .001), according to the presentation.
Moreover, self-reported insomnia and objectively normal sleep was not significantly associated with elevated BP or hypertension compared with the reference group.
‘Not all youth with insomnia are at risk for CV problems’
“We were surprised that insomnia with short sleep duration was strongly associated with hypertension, and that none of the adolescents with insomnia with normal sleep duration had hypertension. Interestingly, short sleep without insomnia complaints was associated with elevated BP,” Fernandez-Mendoza told Healio. “Because objective sleep measures are not typically available in routine care and the data spoke about prevalence, these findings suggest that adolescents with insomnia complaints who have elevated BP or hypertension should undergo a sleep study to unfold whether they suffer from sleep apnea, short sleep duration or even both. This can change the way they receive therapy, as clinicians may direct specific treatment approaches such as those that lengthen sleep duration if behavioral therapy for insomnia is not successful.
“These data can help alleviate worries and concerns in youth and their parents that not all youth with insomnia are at risk for CV problems and that the best approach is to always pay attention to the sleep complaints of the teen, evaluate them subjectively with sleep diaries and then objectively either in the sleep lab or with ambulatory monitoring,” Fernandez-Mendoza said.
For more information:
Julio Fernandez-Mendoza, PhD, CBSM, DBSM, can be reached at jfernandezmendoza@pennstatehealth.psu.edu.
Collapse
Fernandez-Mendoza J, et al. Moderated poster 13. Presented at: Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions; March 6-9, 2025; New Orleans.