Center for Investigation and Research in Sleep Department of Medicine Lausanne University Hospital and University of Lausanne Lausanne Switzerland.
Flinders Health and Medical Research Institute: Sleep Health/Adelaide Institute for Sleep HealthFlinders UniversityCollege of Medicine and Public Health Adelaide Adelaide SA Australia.
J Am Heart Assoc. 2022 Jul 19;11(14):e025828. doi: 10.1161/JAHA.121.025828. Epub 2022 Jul 5.
Background Poor sleep quality is associated with increased incident hypertension. However, few studies have investigated the impact of objective sleep structure parameters on hypertension. This study investigated the association between sleep macrostructural and microstructural parameters and incident hypertension in a middle- to older-aged sample. Methods and Results Participants from the HypnoLaus population-based cohort without hypertension at baseline were included. Participants had at-home polysomnography at baseline, allowing assessment of sleep macrostructure (nonrapid eye movement sleep stages 1, 2, and 3; rapid eye movement sleep stages; and total sleep time) and microstructure including power spectral density of electroencephalogram in nonrapid eye movement sleep and spindles characteristics (density, duration, frequency, amplitude) in nonrapid eye movement sleep stage 2. Associations between sleep macrostructure and microstructure parameters at baseline and incident clinical hypertension over a mean follow-up of 5.2 years were assessed with multiple-adjusted logistic regression. A total of 1172 participants (42% men; age 55±10 years) were included. Of these, 198 (17%) developed hypertension. After adjustment for confounders, no sleep macrostructure features were associated with incident hypertension. However, low absolute delta and sigma power were significantly associated with incident hypertension where participants in the lowest quartile of delta and sigma had a 1.69-fold (95% CI, 1.00-2.89) and 1.72-fold (95% CI, 1.05-2.82) increased risk of incident hypertension, respectively, versus those in the highest quartile. Lower spindle density (odds ratio, 0.87; 95% CI, 0.76-0.99) and amplitude (odds ratio, 0.98; 95% CI, 0.95-1.00) were also associated with higher incident hypertension. Conclusions Sleep microstructure is associated with incident hypertension. Slow-wave activity and sleep spindles, 2 hallmarks of objective sleep continuity and quality, were inversely and consistently associated with incident hypertension. This supports the protective role of sleep continuity in the development of hypertension.
睡眠质量差与高血压的发生有关。然而，很少有研究调查客观睡眠结构参数对高血压的影响。本研究在中老年人群中调查了睡眠宏观结构和微观结构参数与高血压发生之间的关系。
本研究纳入了 HypnoLaus 基于人群的队列研究中的参与者，这些参与者在基线时没有高血压。参与者在家中进行了多导睡眠图检查，以评估睡眠的宏观结构（非快速眼动睡眠 1 期、2 期和 3 期；快速眼动睡眠期；以及总睡眠时间）和微观结构，包括非快速眼动睡眠期脑电图的功率谱密度和非快速眼动睡眠 2 期的纺锤体特征（密度、持续时间、频率、振幅）。使用多因素逻辑回归评估基线时的睡眠宏观结构和微观结构参数与平均随访 5.2 年后发生临床高血压之间的关联。共纳入 1172 名参与者（42%为男性；年龄 55±10 岁）。其中，198 人（17%）发生高血压。在调整混杂因素后，睡眠宏观结构特征与高血压的发生没有相关性。然而，绝对 delta 和 sigma 功率较低与高血压的发生显著相关，delta 和 sigma 最低四分位数的参与者发生高血压的风险分别是最高四分位数的 1.69 倍（95%CI，1.00-2.89）和 1.72 倍（95%CI，1.05-2.82）。较低的纺锤体密度（比值比，0.87；95%CI，0.76-0.99）和振幅（比值比，0.98；95%CI，0.95-1.00）也与更高的高血压发生率相关。
睡眠微观结构与高血压的发生有关。慢波活动和睡眠纺锤体是客观睡眠连续性和质量的两个标志，与高血压的发生呈负相关且一致。这支持了睡眠连续性在高血压发展中的保护作用。
