Actigraphy-derived sleep duration and its association with blood pressure: NHANES 2011 to 2014

Sleep duration is associated with blood pressure (BP), the leading risk factor for cardiovascular disease. Yet, limited data exists on the relationship between objectively measured sleep duration and BP in a large population. We sought to examine this relationship using data from the 2011-2014 National Health and Nutrition Examination Survey cycles.

Average nighttime sleep duration was estimated from actigraphy using a validated algorithm among 6963 individuals [median age 47 (27) years, 52% women]. SBP and DBP were calculated as the average of up to three measures. Hypertension was defined as SBP at least 130 mmHg, DBP at least 80 mmHg, self-reported use of antihypertensive medication, or a self-reported physician diagnosis of hypertension. Linear and logistic regression assessed sleep duration's association with BP and hypertension.

We observed a U-shaped association between sleep duration and SBP [B 2  = 0.29, 95% confidence interval (95% CI) = 0.10-0.49, P  = 0.0031], with higher SBP values observed at shorter and longer sleep durations. Optimal sleep duration was estimated at 7.5 h, corresponding to SBP of 122 mmHg for men and 115 mmHg for women. The association of sleep duration with DBP was nonsignificant (B 2  = 0.13, P  = 0.067). Sleep durations greater or less than 7 h were not associated with increased odds of hypertension (B = -0.30, 95% CI = -0.73 to 0.12, P  = 0.16).

An objectively measured sleep duration of 7.5 h was associated with optimal SBP in both men and women. Yet, neither short nor long sleep durations were associated with hypertension incidence.