Date: Sept. 2, 2008

Summary: A study of 238 healthy American adolescents found that, overall, teenagers who got poor quality sleep were 3.5 times more likely to have prehypertension – a blood pressure equal to or higher than 90 percent of others in the same age, height and age range.  Those who didn’t get enough sleep were 2.5 times more likely to have prehypertension.

Journal: Circulation

Journal citation: Circulation. 2008; 118: 1-7.

Read the complete article: http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.108.766410v1

Why it’s important: High blood pressure in childhood has been associated with high blood pressure in adulthood, which can lead to several other health problems throughout life. Many previous studies have pointed to insufficient or poor quality sleep as a possible cause of high blood pressure or prehypertension in adolescents. This study more definitively shows sleep problems to be associated with prehypertension. According to Susan Redline, M.D., M.P.H., the study’s lead researcher, “These associations may have a large public health impact.”

What’s already known: Many studies have shown an association between too little sleep and poor quality sleep and hypertension in adults as well as between sleeping problems and obesity and an inability to properly metabolize sugars in both children and adults. Although few studies have directly attempted to measure the connection between sleep problems and hypertension, some previous studies have shown that children and adolescents with sleep apnea have higher blood pressure than their peers. This is the first study to examine a direct connection between insufficient or poor quality sleep and hypertension in children without sleep apnea.

How this study was done: The study consisted of 238 adolescents who had no major illnesses and who did not have sleep apnea (breath stoppage during sleep). The average age of the participants was 13.7 years. Twenty percent of them were overweight, and one-fourth came from households making less than $20,000 per year. The adolescents were first studied for five to seven days at home using a device that monitored wrist activity to determine the amount of time they spent active and resting as well as to determine the quality of their sleep. The device helped researchers determine the time in bed and the time asleep. They then used this to generate a percentage of actual sleep. Sleep less than or equal to 85 percent of time in bed was considered poor quality. Short sleep time was considered to be less than 6.5 hours per day.The, researchers also performed a sleep study on the adolescents for one night to assess the quality of their sleep more fully. 

What was found: Overall, 26 percent of the participants had low sleep efficiency. On average, they got 7.71 hours of sleep on weekdays, and 11 percent got less than 6.5 hours of sleep a night. The researchers also found that 33 of the participants (14 percent) met the criteria for prehypertension. Prehypertension is defined as systolic blood pressure (the top number) of 120-139 mmHg or diastolic blood pressure (the bottom number) of 80-89 mmHg. Those with prehypertension were more likely to be male, overweight, and from neighborhoods with a lower median income. Most importantly, the researchers found that all of the adolescents who were getting poor quality sleep were more likely to have a significantly higher blood pressure than those getting a good night’s rest. After adjusting the data for socioeconomic status, body mass index (which determines overweight) and age, adolescents whose sleep was less efficient than normal were 3.5 times more likely to suffer from high blood pressure. Also, while poor sleep efficiency was more likely to be associated with a risk of higher blood pressure, adolescents who got less sleep were also 2.5 times more likely to have prehypertension. 

“Our study underscores the high rate of poor quality and inadequate sleep in adolescence coupled with the risk of developing high blood pressure and other health problems,” said Dr. Redline, professor of medicine and pediatrics and director of University Hospitals Sleep Center at Case Western Reserve University in Cleveland, Ohio. “We also found that a low sleep efficiency may be more consistently associated with prehypertension than a shorter sleep period.”

The bottom line: Ensuring that a teenager gets both enough and good quality sleep will reduce his or her chances of having high blood pressure both in adolescence and in adulthood and will lead to a healthier, longer life.



This content is reviewed regularly. Last updated 9/22/08.