Insomniacs who take longer than 14 minutes to fall asleep face a greater risk of hypertension, according to new research in the American Heart Association journal Hypertension.
The study, conducted at West China Hospital, is the first to test whether insomnia with physiological hyperarousal, defined as a longer time to fall asleep, is linked to hypertension.
"We observed a strong correlation between the degree of physiological hyperarousal and hypertension," said Xiangdong Tang M.D., Ph.D, co- author of the study and professor of sleep medicine at West China Hospital, Sichuan University in Chengdu, China.
"In other words, those insomniacs who were hyperalert during the day and unable to relax and fall asleep during the Multiple Latency Sleep Test (MSLT) had the higher risk of hypertension," said study co-author Alexandros Vgontzas, M.D., professor of sleep research and treatment in the Department of Psychiatry at Pennsylvania State University College of Medicine in Hershey, Penn.
Insomnia is the most prevalent sleep disorder in the general population. One-fourth to one-third of the general population complains of difficuly falling asleep and about 10 percent have chronic complaints and seek medical help for insomnia.
Researchers studied 219 chronic insomniacs and 96 normal sleepers (average age 40 and more than 60 percent women). They defined chronic insomnia as difficulty sleeping for more than six months.
The participants spent one night monitored in a sleep lab and took the MLST the next day. Monitoring included four 20-minute nap opportunities at two-hour intervals: 9 a.m., 11 a.m., 1 p.m. and 3 p.m. Half the participants took 14 minutes or less to fall asleep and half took more than 14 minutes to fall asleep. Those that took more than 14 minutes to fall asleep were considered "hyperaroused."
Hypertension was based on blood pressure measures or a physician's diagnosis. Researchers controlled for confounding factors such as obesity, sleep apnea, diabetes, smoking, alcohol and caffeine use.
Chronic insomnia combined with an MSLT score greater than 14 minutes increased the odds of hypertension by 300 percent. MSLT scores greater than 17 minutes increased the odds by 400 percent.
"Long latency times to fall asleep during the day may be a reliable index of the physiological hyperarousal and biological severity of the disorder," Vgontzas said.
Traditionally, insomnia has been perceived as a nighttime sleep disorder; however, several studies suggest it's a state of 24-hour hyperarousal.
A more biologically severe type of insomnia is associated with 24-hour hyperarousal and significant cardiometabolic consequences like hypertension. The less severe form has primarily psychological roots.
Feeling hyperalert or sleepy doesn't allow people to function at their best, feel well during the day or sleep well at night, Vgontzas said.
"Although insomniacs complain of fatigue and tiredness during the day, their problem is that they cannot relax and that they are hyper," he said. "Measures that apply in sleep-deprived normal sleepers—napping, caffeine use or other stimulants to combat fatigue—do not apply in insomniacs. In fact, excessive caffeine worsens the hyperarousal."
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Insomniacs who take longer than 14 minutes to fall asleep face a greater risk of hypertension, according to new research in the American Heart Association journal Hypertension.
The study, conducted at West China Hospital, is the first to test whether insomnia with physiological hyperarousal, defined as a longer time to fall asleep, is linked to hypertension.
"We observed a strong correlation between the degree of physiological hyperarousal and hypertension," said Xiangdong Tang M.D., Ph.D, co- author of the study and professor of sleep medicine at West China Hospital, Sichuan University in Chengdu, China.
"In other words, those insomniacs who were hyperalert during the day and unable to relax and fall asleep during the Multiple Latency Sleep Test (MSLT) had the higher risk of hypertension," said study co-author Alexandros Vgontzas, M.D., professor of sleep research and treatment in the Department of Psychiatry at Pennsylvania State University College of Medicine in Hershey, Penn.
Insomnia is the most prevalent sleep disorder in the general population. One-fourth to one-third of the general population complains of difficuly falling asleep and about 10 percent have chronic complaints and seek medical help for insomnia.
Researchers studied 219 chronic insomniacs and 96 normal sleepers (average age 40 and more than 60 percent women). They defined chronic insomnia as difficulty sleeping for more than six months.
The participants spent one night monitored in a sleep lab and took the MLST the next day. Monitoring included four 20-minute nap opportunities at two-hour intervals: 9 a.m., 11 a.m., 1 p.m. and 3 p.m. Half the participants took 14 minutes or less to fall asleep and half took more than 14 minutes to fall asleep. Those that took more than 14 minutes to fall asleep were considered "hyperaroused."
Hypertension was based on blood pressure measures or a physician's diagnosis. Researchers controlled for confounding factors such as obesity, sleep apnea, diabetes, smoking, alcohol and caffeine use.
Chronic insomnia combined with an MSLT score greater than 14 minutes increased the odds of hypertension by 300 percent. MSLT scores greater than 17 minutes increased the odds by 400 percent.
"Long latency times to fall asleep during the day may be a reliable index of the physiological hyperarousal and biological severity of the disorder," Vgontzas said.
Traditionally, insomnia has been perceived as a nighttime sleep disorder; however, several studies suggest it's a state of 24-hour hyperarousal.
A more biologically severe type of insomnia is associated with 24-hour hyperarousal and significant cardiometabolic consequences like hypertension. The less severe form has primarily psychological roots.
Feeling hyperalert or sleepy doesn't allow people to function at their best, feel well during the day or sleep well at night, Vgontzas said.
"Although insomniacs complain of fatigue and tiredness during the day, their problem is that they cannot relax and that they are hyper," he said. "Measures that apply in sleep-deprived normal sleepers—napping, caffeine use or other stimulants to combat fatigue—do not apply in insomniacs. In fact, excessive caffeine worsens the hyperarousal."
Explore further: Power naps for insomniacs
Medical Xpress on facebook
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Study: Insomnia linked to hypertension
Jun 06, 2012
People with insomnia may now have one more thing to keep them up at night: an increased likelihood of developing hypertension, according to a study from Henry Ford Hospital in Detroit.
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Jan 23, 2015
Daytime naps may hold the key to treating insomnia, Flinders University researchers believe.
Study finds an increased risk of death in men with insomnia and a short sleep duration
Sep 01, 2010
A study in the Sept. 1 issue of the journal Sleep found an elevated risk of death in men with a complaint of chronic insomnia and an objectively measured short sleep duration. The results suggest that public health policy ...
Alcohol interferes with body's ability to regulate sleep, researchers find
Dec 10, 2014
Researchers from the University of Missouri School of Medicine have found that drinking alcohol to fall asleep interferes with sleep homeostasis, the body's sleep-regulating mechanism.
A similarity in the meaning of sleep quality between insomniacs, normal sleepers
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Both insomnia patients and normal sleepers define sleep quality by tiredness upon waking and throughout the day, feeling rested and restored upon waking, and the number of awakenings they experienced in the night. Further, ...
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2 minutes ago
Most young adults might assume they have years before needing to worry about their cholesterol.
Study shows risk for younger adults with isolated systolic hypertension
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Younger adults with elevated systolic blood pressure—the top number in the blood pressure reading—have a higher risk for cardiovascular disease and coronary heart disease than those with normal blood ...
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Initial diagnostic test in ED for chest pain did not affect low rate of heart attack
5 hours ago
Patients seen in the emergency department (ED) for chest pain who did not have a heart attack appeared to be at low risk of experiencing a heart attack during short- and longer-term follow-up and that risk was not affected ...
Should hospitals keep cardiac catheterization labs open on weekends?
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For patients experiencing non-ST-segment elevation acute coronary syndromes (NSTE-ACS), a rapid invasive strategy (within 24 hours) using coronary angiography and other interventions is beneficial for high-risk as well as ...
More variation in costs than outcomes of PCI in VA system
Jan 23, 2015
(HealthDay)—For patients undergoing percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) system, the variation in one-year risk-adjusted mortality is smaller than variation in risk-standardized ...
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