Association of sleep duration and hypertension in older adults: a cross-sectional study

Sleep duration, a modifiable lifestyle factor, has been variably associated with blood pressure regulation, yet evidence among the oldest-old populations remains limited and inconsistent. This study aims to investigate the association between self-reported sleep duration and hypertension in a large cohort of Chinese older adults.

We analysed cross-sectional data from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 15,650 participants aged 65 years and older were included. Sleep duration was self-reported and categorised as <6 h, 6-8 h, and ≥9 h. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or a self-reported physician diagnosis. Multivariate logistic regression models were used to evaluate the associations. Restricted cubic splines were applied to model non-linearity.

Among 15,650 participants (mean age 87.16 years, SD 11.36; 57.0% female), 7,345 (46.9%) met criteria for hypertension. In the fully adjusted model, short sleep duration (<6 h) was associated with a 1.30-fold higher odds of hypertension compared with sleeping 6-9 h (adjusted odds ratio [OR] 1.30; 95% confidence interval [CI] 1.17, 1.44). Long sleep duration (≥9 h) showed no statistically significant association after full adjustment (OR 1.04; 95% CI 0.97, 1.12). The relationship followed a non-linear J-shaped curve (p for non-linearity < 0.05). Interaction analyses revealed that the effect of short sleep duration on hypertension was more pronounced among adults with no limitations in activities of daily living (p for interaction = 0.009).

Short sleep duration (<6 h) is independently associated with hypertension in Chinese older adults. These findings suggest sleep assessment may help identify older adults at hypertension risk, and support future trials on sleep hygiene for hypertension prevention.