Sleep health matters for blood pressure: Actigraphy-based evidence from a Chinese adult population

This study aimed to assess how sleep health links to blood pressure and hypertension in a community cohort of Hong Kong Chinese adults.

This cross-sectional study was conducted in Hong Kong, and participants answered multiple questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and Nonrestorative Sleep Scale (NRSS). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were collected via a portable monitor, while objective sleep parameters were derived from data acquired using an ActiGraph Link accelerometer. A composite sleep health score was generated by combining actigraphy-derived dimensions (efficiency, regularity, duration, timing) with subjectively reported dimensions (satisfaction and alertness based on the PSQI and NRSS, respectively). Linear and logistic regression models were applied to examine the associations between sleep health and blood pressure and hypertension.

The final sample comprised 500 adults (66.4% female) with a mean age of 39 years. The average sleep health score was 2.67 (SD = 1.36), and averages for SBP and DBP were 116.2 (SD = 12.17) and 75.4 (SD = 7.97) mmHg, respectively. After controlling for sociodemographics, lifestyle factors, hypertension diagnosis, somatic symptoms, and stress, individuals scoring 5-6 on sleep health had SBP and DBP levels 4.06 mmHg (p = 0.031) and 3.01 mmHg (p = 0.035) lower, respectively, compared with those scoring 0-2. Sleep regularity domain was associated with SBP (b = -2.43, p = 0.029) and DBP (b = -1.93, p = 0.022) after additionally adjusting for other domains of sleep health. Moreover, individuals with better sleep timing had a lower risk of hypertension (OR = 0.25, p = 0.043).

Sleep health is critical for promoting cardiovascular disease prevention.