ArticleFrontiers in public health2025
Asymmetric U-shaped association between hypertension and wearable-derived sleep duration.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate associations between hypertension and wearable-derived sleep duration, including Sleep Period Time (SPT) and Total Sleep Time (TST), in community-dwelling adults. Methods: In this cross-sectional study, nocturnal SPT and TST were objectively quantified from single-lead electrocardiograms and analyzed using multimodal regression approaches including covariate-adjusted binary logistic regression, restricted cubic splines, and segmented linear regression. Results: Our analysis of 1,459 valid sleep records from 759 participants showed asymmetric U-shaped associations between objective sleep duration and both hypertension prevalence and blood pressure levels. After adjusting for confounding factors, participants with SPT < 6 h had a 2.05-fold higher prevalence of hypertension (95% CI: 1.18-3.54), while those with TST ≥ 8 h had a 1.82-fold increased odds (95% CI: 1.03-3.22). For SPT, blood pressure nadirs occurred at 7.6-7.7 h for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). For TST, the optimal duration was 7.0-7.2 h in different models. Below optimal SPT thresholds, each 1-h increase was associated with a reduction of 2.94 mmHg in SBP (95% CI: -4.82 to -1.06) and 1.21 mmHg (95% CI: -2.05 to -0.36) in DBP. In partially adjusted models, each 1-h increase above the optimal SPT was associated with an increase in SBP of 2.27 mmHg (95% CI: 0.15 to 4.39). This effect was no longer significant in the fully adjusted analysis. For TST, similar dose-response patterns were significant only for DBP, in partially adjusted models. Conclusion: Wearable-derived objective sleep duration demonstrates an asymmetric U-shaped association with both hypertension prevalence and blood pressure parameters. Blood pressure nadirs occurred at 7.6-7.7 h for SPT and 7.0-7.2 h for TST.
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