The interrelationships between sleep regularity, obstructive sleep apnea, and hypertension in a middle-aged community population

Author:

Sansom Kelly123ORCID,Reynolds Amy3ORCID,Windred Daniel4ORCID,Phillips Andrew4ORCID,Dhaliwal Satvinder S5678,Walsh Jennifer129ORCID,Maddison Kathleen129,Singh Bhajan129,Eastwood Peter10ORCID,McArdle Nigel129ORCID

Affiliation:

1. Centre for Sleep Science, School of Human Sciences, University of Western Australia , Perth, WA , Australia

2. Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute , Nedlands, WA , Australia

3. Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute - Sleep Health , Adelaide, SA , Australia

4. School of Psychological Sciences, Monash University, Turner Institute for Brain and Mental Health , Clayton, VIC , Australia

5. Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University , Bentley, WA , Australia

6. Office of the Provost, Singapore University of Social Sciences , Clementi , Singapore

7. Duke-NUS Medical School, National University of Singapore , Singapore

8. Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia , Pulau Pinang , Malaysia

9. Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital , Perth, WA , Australia

10. Health Futures Institute, Murdoch University , Perth, WA , Australia

Abstract

Abstract Study Objectives Little is known about the interrelationships between sleep regularity, obstructive sleep apnea (OSA) and important health markers. This study examined whether irregular sleep is associated with OSA and hypertension, and if this modifies the known association between OSA and hypertension. Methods Six hundred and two adults (age mean(SD) = 56.96(5.51) years, female = 60%) from the Raine Study who were not evening or night shift workers were assessed for OSA (in-laboratory polysomnography; apnea–hypopnea index ≥ 15 events/hour), hypertension (doctor diagnosed, or systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg) and sleep (wrist actigraphy for ≥5 days). A sleep regularity index (SRI) was determined from actigraphy. Participants were categorized by tertiles as severely irregular, mildly irregular, or regular sleepers. Logistic regression models examined the interrelationships between SRI, OSA and hypertension. Covariates included age, sex, body mass index, actigraphy sleep duration, insomnia, depression, activity, alcohol, smoking, and antihypertensive medication. Results Compared to regular sleepers, participants with mildly irregular (OR 1.97, 95% confidence intervals [CI] 1.20 to 3.27) and severely irregular (OR 2.06, 95% CI: 1.25 to 3.42) sleep had greater odds of OSA. Compared to those with no OSA and regular sleep, OSA and severely irregular sleep combined had the highest odds of hypertension (OR 2.34 95% CI: 1.07 to 5.12; p for interaction = 0.02) while those with OSA and regular/mildly irregular sleep were not at increased risk (p for interaction = 0.20). Conclusions Sleep irregularity may be an important modifiable target for hypertension among those with OSA.

Funder

Australian Government Research Training Program

Publisher

Oxford University Press (OUP)

Reference53 articles.

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