Sleep efficiency is negatively associated with resting daytime heart rate in trauma-exposed premenopausal women

Poor sleep is associated with increased cardiovascular events and mortality. Women are typically more exposed to interpersonal trauma than men and may be vulnerable to sleep disturbances as sequelae of trauma. Yet, the association between poor sleep and cardiovascular biomarkers such as resting blood pressure (BP) and heart rate (HR) in young trauma-exposed women has not been well elucidated. We hypothesized that sleep quality would be associated with resting daytime BP and HR, independently of other factors. We recruited 131 otherwise healthy trauma-exposed premenopausal women and measured resting daytime BP and HR using automated vital signs monitor and peripheral arterial tonometry. Participants wore wrist actigraphy for 7 days to assess objective sleep along with a sleep diary and completed two sleep questionnaires: the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). Our analyses revealed that objective sleep efficiency was negatively correlated with (r = -0.222, p = 0.010) and was a significant predictor of (β = -0.206, p = 0.008) resting supine HR, even after controlling for age, BMI, BP, PCL-5, and medication use for depression, anxiety, and sleep (R² = 0.253, p = 0.008). There was a weak correlation between ISI and diastolic BP (r = 0.192, p = 0.026). These results underscore the potential role of sleep in mental health-associated cardiovascular disease.