Exploring the impact of short sleep on hypertension prevalence in the Chinese population: dose- response relationships, standardization, and health behaviors

Abstract

Abstract Background The concept of short sleep remains ambiguous, which is exacerbated by the presence of ethnic differences that contribute to variations in the correlation between short sleep and the risk of hypertension. Additionally, methodological constraints have led to abundant heterogeneous evidence concerning the link between short sleep and hypertension risk, compelling the need to further investigate the relationship between short sleep and hypertension risk in the Chinese population. This study investigate the impact of short sleep on hypertension prevalence in the Chinese population, analyze the dose-response relationship between sleep duration and the risk of hypertension, establish a standard concept of short sleep to balance the confounding factors between groups, and determine the true association between short sleep and the prevalence of hypertension. Methods Using the cross-sectional data from the Chinese Psychological and Behavioural Study of the Population (PBICR) 2020. Dose-response relationships between sleep duration and hypertension risk were assessed using restricted cubic spline models. A binary logistic regression model with propensity score matching was used to investigate the true association between short sleep duration and hypertension risk in the Chinese population. In addition, binary logistic regression models were used to analyze the association between >5 hours of sleep and hypertension risks and the effect of health behaviors on the risk of hypertension in short sleepers. Results The relationship between sleep duration and hypertension risk demonstrated a notable non-linear U-shaped pattern. Following propensity score matching, we observed that among those sleeping ≤5 hours/day, the risk of developing hypertension was reduced by 32% (OR=0.680) for each 1-hour increase in sleep duration. However, in the whole population sleeping >5 hours/day, sleep did not affect the risk of developing hypertension. In the population with ≤5 hours of sleep/day, smoking (OR=2.280) and working in a fixed position for a long period of time (OR=2.034) increased hypertension risk, and having at least one physical activity maintained for more than six months led to reduced hypertension risks (OR=0.363). Conclusion The threshold of 5-hour sleep represents a key turning point for hypertension in the investigated Chinese population and could be considered for defining short sleep. Additionally, cessation of smoking, vigilant posture alterations during work, and consistent adherence to exercise regimens can reduce the risk of hypertension in people with short sleep duration.