Association of night sleep duration and with blood pressure control: a cross-sectional survey among adult hypertension patients in communities of Nanjing city

  Objective   To investigate the relationship between sleep duration and blood pressure control among community adult hypertension patients for providing evidence to blood pressure control in the population.

  Methods   The participants of the study were 15 686 hypertension patients identified from 61 098 adult residents (aged ≥ 18 years) recruited with stratified multi-stage cluster sampling for the Nanjing Chronic Disease and Risk Factor Surveillance in communities of 5 districts of Nanjing city. Face-to-face interview with a self-designed questionnaire and International Physical Activity Questionnaire (IPAQ), physical examination and laboratory tests were conducted among all the residents during January 2017 – June 2018. Multiple logistic regression model was used to analyze the association of sleep duration with blood pressure control of the hypertension patients.

  Results   Of all the hypertension patients, 45.1% (7 082) were assessed as having effective blood pressure control (systolic blood pressure <140 mm Hg and/or diastolic pressure <90 mm Hg) and the proportions of effective blood pressure control were 43.8%, 45.6%, 47.2%, 43.7%, and 40.2% for the patients reporting the night sleep duration of < 6.0 , 6.0 – 6.9 , 7.0 – 7.9 , 8.0 – 8.9, and ≥ 9.0 hours per day (h/d), respectively, with a significant difference (χ² = 23.354, P < 0.001). After adjusting for gender, age, residential area, education, smoking, alcohol consumption, physical activity, body mass index, diabetes, dyslipidemia, and anti-hypertensive medication, the results of multivariate logistic regression analysis for all hypertension patients revealed that compared to the patients with the sleep duration of 7.0 – 7.9 h/d, those with a shorter or longer sleep duration were less likely to have an effective blood pressure control (for sleep duration of < 6 h/d: odds ratio OR = 0.88, 95% confidence interval 95%CI: 0.77 – 0.99; for sleep duration of ≥ 9 h/d: OR = 0.75, 95%CI: 0.65 – 0.87); further analysis using the comparison groups with the sleep duration of 7.0 – 7.9 h/d also showed that some subgroups with a shorter or longer sleep duration were also less likely to have an effective blood pressure control: (1) the male patients with the sleep duration of < 6 h/d (OR = 0.74, 95%CI: 0.62 – 0.89), 8.0 – 8.9 h/d (OR = 0.86, 95%CI: 0.76 – 0.95) or ≥ 9 h/d (OR = 0.75, 95%CI: 0.65 – 0.87); (2) the female patients with sleep duration of ≥ 9 h/d (OR = 0.73 95%CI: 0.59 – 0.91); (3) the elderly patients (aged ≥ 60 years) with the sleep duration of < 6 h/d (OR = 0.80, 95%CI: 0.68 – 0.94) or ≥ 9 h/d (OR = 0.68, 95%CI: 0.56 – 0.83).

  Conclusion   The study results suggest that night sleep duration is associated with effective blood pressure control among community adult hypertension patients, especially among those being male and those aged 60 years and above.