Association between sleep duration and hypertension risk in patients with obstructive sleep apnea

Abstract Obstructive sleep apnea (OSA) is a well-established risk factor for hypertension, with sleep duration being a modifiable factor influencing this risk. However, sleep misperception among OSA patients makes it unclear how subjective and objective sleep duration are associated with the prevale...

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Main Authors: Yi Wang, Xi Xi Chen, Fang Ying Lu, Ya Ru Yan, Shi Qi Li, Liu Zhang, Ying Ni Lin, Qing Yun Li
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:npj Primary Care Respiratory Medicine
Online Access:https://doi.org/10.1038/s41533-025-00429-7
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author Yi Wang
Xi Xi Chen
Fang Ying Lu
Ya Ru Yan
Shi Qi Li
Liu Zhang
Ying Ni Lin
Qing Yun Li
author_facet Yi Wang
Xi Xi Chen
Fang Ying Lu
Ya Ru Yan
Shi Qi Li
Liu Zhang
Ying Ni Lin
Qing Yun Li
author_sort Yi Wang
collection DOAJ
description Abstract Obstructive sleep apnea (OSA) is a well-established risk factor for hypertension, with sleep duration being a modifiable factor influencing this risk. However, sleep misperception among OSA patients makes it unclear how subjective and objective sleep duration are associated with the prevalence and incidence of hypertension in this population. This study aims to examine these associations using data from the Sleep Heart Health Study cohort. Participants with OSA (apnea-hypopnea index ≥ 15 events/hour) were categorized based on objective sleep duration from polysomnography (PSGTST) and subjective sleep duration (morning-reported sleep time, AMTST; habitual sleep time, HABTST). Hypertension prevalence was assessed at baseline, while hypertension incidence was evaluated during a five-year follow-up. Multivariable logistic regression and Poisson log-link models were employed to explore the association between sleep duration and hypertension risk, with restricted cubic splines used to assess nonlinear trends. Among 2574 participants with OSA, 1263 had hypertension at baseline. Over 5.25 years, 376 of 1001 patients without baseline hypertension developed hypertension. Shorter PSGTST was linearly associated with higher hypertension prevalence (p = 0.009) and incidence (p = 0.024). HABTST showed a U-shaped relationship with hypertension prevalence, while AMTST was not significantly associated with either outcome. In patients with OSA, objective sleep duration is linearly and inversely associated with both the prevalence and incidence of hypertension, showing stronger and more consistent associations than subjective sleep duration measures. These findings highlight the value of incorporating objective sleep assessment in evaluating hypertension risk in this population.
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spelling doaj-art-d38aacd0f2f44745a0e1841f49000c792025-08-20T03:52:24ZengNature Portfolionpj Primary Care Respiratory Medicine2055-10102025-04-013511810.1038/s41533-025-00429-7Association between sleep duration and hypertension risk in patients with obstructive sleep apneaYi Wang0Xi Xi Chen1Fang Ying Lu2Ya Ru Yan3Shi Qi Li4Liu Zhang5Ying Ni Lin6Qing Yun Li7Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Obstructive sleep apnea (OSA) is a well-established risk factor for hypertension, with sleep duration being a modifiable factor influencing this risk. However, sleep misperception among OSA patients makes it unclear how subjective and objective sleep duration are associated with the prevalence and incidence of hypertension in this population. This study aims to examine these associations using data from the Sleep Heart Health Study cohort. Participants with OSA (apnea-hypopnea index ≥ 15 events/hour) were categorized based on objective sleep duration from polysomnography (PSGTST) and subjective sleep duration (morning-reported sleep time, AMTST; habitual sleep time, HABTST). Hypertension prevalence was assessed at baseline, while hypertension incidence was evaluated during a five-year follow-up. Multivariable logistic regression and Poisson log-link models were employed to explore the association between sleep duration and hypertension risk, with restricted cubic splines used to assess nonlinear trends. Among 2574 participants with OSA, 1263 had hypertension at baseline. Over 5.25 years, 376 of 1001 patients without baseline hypertension developed hypertension. Shorter PSGTST was linearly associated with higher hypertension prevalence (p = 0.009) and incidence (p = 0.024). HABTST showed a U-shaped relationship with hypertension prevalence, while AMTST was not significantly associated with either outcome. In patients with OSA, objective sleep duration is linearly and inversely associated with both the prevalence and incidence of hypertension, showing stronger and more consistent associations than subjective sleep duration measures. These findings highlight the value of incorporating objective sleep assessment in evaluating hypertension risk in this population.https://doi.org/10.1038/s41533-025-00429-7
spellingShingle Yi Wang
Xi Xi Chen
Fang Ying Lu
Ya Ru Yan
Shi Qi Li
Liu Zhang
Ying Ni Lin
Qing Yun Li
Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
npj Primary Care Respiratory Medicine
title Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
title_full Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
title_fullStr Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
title_full_unstemmed Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
title_short Association between sleep duration and hypertension risk in patients with obstructive sleep apnea
title_sort association between sleep duration and hypertension risk in patients with obstructive sleep apnea
url https://doi.org/10.1038/s41533-025-00429-7
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