Insufficient sleep induces persistent elevation in blood pressure

Shortened sleep duration causes persistent elevation in 24-hour and sleep-time blood pressure (BP), and this elevation is especially pronounced and sustained in women, a study has found.

A team of researchers examined the impact of prolonged sleep restriction on 24-hour ambulatory BP and other cardiovascular measures. They randomized 20 healthy young participants (mean age 23.4 years, nine females) to undergo a 16-day inpatient study, which consisted of 4 days of acclimation, 9 days of sleep restriction (4 hours of sleep/night) or control sleep (9 hours), and 3 days of recovery.

All participants followed a weight maintenance diet with controlled nutrient composition throughout the trial. They were on continuous polysomnographic monitoring and underwent repeated measurements of 24-hour BP, the primary outcome, and cardiovascular biomarkers. 

Compared with control sleep, sleep restriction resulted in a marked increase in 24-hour mean BP at day 12 (adjusted mean difference, 2.1 mm Hg, 95 percent confidence interval [CI], 0.6–3.6; p=0.016), attenuation in endothelial function (p<0.001), and rise in plasma norepinephrine (p=0.011).

Furthermore, in the sleep restriction group, BP was elevated while asleep and during recovery despite increased deep sleep.

Post hoc analysis showed that 24-hour BP, wakefulness, and sleep BP climbed during experimental and recovery phases of sleep restriction in women but not men. The female participants showed an increase of 8.0 mm Hg in 24-hour systolic BP and of 11.3 mm Hg in sleep systolic BP (p<0.001 for both).

The findings suggest that women are more vulnerable to the adverse cardiovascular effects of sleep loss.