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May 14, 2026Physiology0 citations

The association between habitual sleep metrics and blood pressure reactivity to sympathoexcitatory stimuli in premenopausal females

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WBWesley BlumenburgJMJosh MasonCWChad Wiggins

Key Result

Shorter total sleep time correlated with increased SBP reactivity during CPT (r=-0.616, P=0.001), and lower sleep efficiency was associated with higher resting SBP (r=-0.434, P=0.030).

Key Points

  • The aim was to examine how sleep duration and efficiency affect blood pressure responses to stress in premenopausal females.
  • Analyzed 26 premenopausal females aged 21±4 years during sympathoexcitatory tests.
  • Used wrist actigraphy for 10 days to assess sleep metrics.
  • Measured blood pressure responses during isometric handgrip, post-exercise ischemia, and cold pressor tests.
  • Lower sleep efficiency (SE) correlated with higher resting systolic blood pressure (SBP) (r=-0.434, P=0.030).
  • Shorter total sleep time (TST) was linked to increased SBP reactivity during the cold pressor test (r=-0.616, P=0.001).
  • No association was found between TST and SBP responses during isometric handgrip or post-exercise ischemia (P>0.05).

Study Design

Type

Cross-Sectional (n=26)

Structured PICO

Do habitual sleep duration and efficiency correlate with blood pressure reactivity to sympathoexcitatory stimuli in premenopausal females?

P
Population
26 premenopausal females, mean age 21±4 years, BMI 23±3 kg/m2
I
Intervention
Habitual sleep metrics (total sleep time and sleep efficiency) assessed via wrist actigraphy for 10 consecutive days
O
Outcome
Changes in systolic blood pressure (ΔSBP) during sympathoexcitatory tests (isometric handgrip, post-exercise ischemia, and cold pressor test)surrogate

Lower habitual sleep efficiency and shorter sleep duration are associated with heightened systolic blood pressure reactivity to sympathetic stimuli in premenopausal females.

Main Result

Effect estimate: r=-0.616

p-value: p=0.001

Limitations

  • Missing data for some tests (PEI n=24)

Abstract

BACKGROUND: Sleep is an important factor for cardiovascular health, with habitual sleep duration and efficiency associated with blood pressure (BP) both at rest and during sympathoexcitatory stimuli. However, previous research has focused on males or utilized mixed-sex samples, limiting the extrapolation of these findings to female populations. Our aim was to examine the relationship between sleep duration and efficiency on BP responses to sympathoexcitatory stimuli in premenopausal females. We hypothesized that sleep duration and sleep efficiency (SE) would be inversely associated with BP reactivity during sympathoexcitatory stimuli. METHODS: 26 females (21±4yrs; body mass index: 23±3kg/m2) were recruited. Following a period of supine rest (>10min), participants performed a 3-min isometric handgrip (IHG) exercise bout at 30% of maximum voluntary contraction, followed by 3-min of post-exercise ischemia (PEI) via brachial cuff-occlusion at 240mmHg. Participants then rested for 15-min, after which they performed a cold pressor test (CPT) for up to 3-min. Beat-by-beat BP was measured throughout each test. Baseline BP was calculated as the average over a 5-min period prior to each test. Changes (Δ) in systolic (SBP) were determined from the final minute of IHG and PEI, and the final 30-s of the CPT. Average total sleep time (TST) and SE were assessed using wrist actigraphy monitors worn for 10 consecutive days. Associations between habitual sleep metrics, resting SBP, and ΔSBP during sympathoexcitatory tests were assessed using partial Pearson correlations controlling for sleep duration prior to testing. RESULTS: For all participants, BP (mmHg) at rest was 110±10 for SBP, 66±7 for diastolic BP, and 83±8 for mean arterial pressure. Additionally, habitual TST was 454±53min and SE was 91±4%. Due to missing data, sample sizes differed across sympathoexcitatory tests (IHG and CPT: n=26; PEI: n=24). Low SE was associated with greater SBP at rest (r=-0.434, P=0.030) and during the IHG (r=-0.405, P=0.045), but not PEI or CPT (P>0.05). TST was not associated with resting SBP (P>0.05). However, shorter TST was correlated with increased SBP reactivity during the CPT (r=-0.616, P=0.001). No association was observed between TST and SBP responses to IHG or PEI (P>0.05). CONCLUSION: These findings suggest that lower habitual SE is associated with higher SBP at rest and during exercise pressor reflex activation in premenopausal females. Additionally, shorter habitual TST was associated with increased SBP during general sympathetic activation. Collectively, these results underscore the multidimensional nature of sleep and suggest that distinct components of habitual sleep may impact BP regulatory reflexes in premenopausal females. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

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Cite This Study

Blumenburg et al. (2026) conducted a cross-sectional in Healthy premenopausal females (n=26). Habitual sleep metrics (sleep duration and efficiency) was evaluated on Blood pressure reactivity to sympathoexcitatory stimuli (r=-0.616, p=0.001). Shorter total sleep time correlated with increased SBP reactivity during CPT (r=-0.616, P=0.001), and lower sleep efficiency was associated with higher resting SBP (r=-0.434, P=0.030).

synapsesocial.com/papers/6a056767a550a87e60a1f714https://doi.org/10.1152/physiol.2026.41.s1.2299102
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