Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension

STUDY OBJECTIVES: To examine the joint effect of insomnia and objective short sleep duration on hypertension risk. DESIGN: Representative cross-sectional study. SETTING: Sleep laboratory. PARTICIPANTS: 1,741 men and women randomly selected from central Pennsylvania. INTERVENTIONS: None. MEASUREMENTS: Insomnia was defined by a complaint of insomnia with a duration > or = 1 year, while poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, or early final awakening. Polysomnographic sleep duration was classified into 3 categories: > or = 6 h sleep (top 50% of the sample); 5-6 h (approximately the third quartile of the sample); and 6 h sleep duration group, the highest risk of hypertension was in insomnia with < 5 h sleep duration group (OR 95% CI 5.1 2.2, 11.8), and the second highest in insomnia who slept 5-6 hours (OR 3.5 1.6, 7.9 P < 0.01). The risk for hypertension was significantly higher, but of lesser magnitude, in poor sleepers with short sleep duration. CONCLUSIONS: Insomnia with short sleep duration is associated with increased risk of hypertension, to a degree comparable to that of other common sleep disorders, e.g., SDB. Objective sleep duration may predict the severity of chronic insomnia a prevalent condition whose medical impact has been apparently underestimated.