Sleeping Difficulties, Sleep Duration, and Risk of Hypertension in Women

Background: Rates of poor sleep and hypertension are alarming worldwide. In this study, we investigate the association between sleeping difficulties and sleep duration with hypertension risk in women.

Methods: Sixty-six thousand one hundred twenty-two participants of the Nurses' Health Study 2, who were free of hypertension at baseline (2001), were followed prospectively for 16 years and incident hypertension assessed every 2 years. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for hypertension incidence associated with sleeping difficulties and sleep duration.

Results: During follow-up, we documented 25 987 incident cases of hypertension. After controlling for demographic and lifestyle risk factors, compared with women who slept 7 to 8 hours, women with shorter sleep duration had a significantly higher risk of hypertension (≤5 hours: HR, 1.10 [95% CI, 1.05-1.16]; 6 hours: HR, 1.07 [95% CI, 1.03-1.10]), whereas the risk for women with longer sleep duration was not statistically significant (9 hours: HR, 1.03 [95% CI, 0.97-1.10]; >9 hours: HR, 1.08 [95% CI, 0.94-1.23]). Compared with women rarely having difficulty falling or staying asleep, women sometimes or usually having these sleep difficulties had significantly higher risk of developing hypertension (HR, 1.14 [95% CI, 1.11-1.17] and 1.28 [95% CI, 1.22-1.35]; <0.001). Early morning awakening was not associated with hypertension risk (=0.722). There was no effect modification by night work or chronotype.

Conclusions: Difficulty falling or staying asleep and short sleep duration were associated with higher risk of hypertension among women in our study. Screening for poor sleep could be useful in identifying people at higher risk for hypertension.