Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States (US), contributing to one in three deaths. It is estimated that more than 120 million Americans are living with at least one form of CVD, which include hypertension (HTN). HTN accounts for the highest prevalence, impacting over 50% of individuals aged ≥20 years old in the US. Suboptimal sleep also represents a notable CVD risk factor and has been identified as a contributor to various CVD-related issues. The inclusion of sleep health as one of the Life’s Essential 8 measures in 2022 reinforces its importance for overall well-being and underscores its significance in the prevention of CV. Suboptimal sleep is a risk factor HTN and CVD. However, the association between sleep disturbances and HTN among US adults is unclear.

Objective: To examine the relationship between HTN and sleep disturbances among adults in the U.S. We hypothesized that individuals diagnosed with HTN were more likely to have higher sleep disturbance scores.

Methods: We used a cross-sectional design to examine data from the 2013-2018 National Health Interview Survey. We computed a sleep disturbance score, composite of five components of suboptimal sleep: sleep duration, trouble falling asleep, staying asleep, sleep medication use, and restful sleep. Survey-weighted multinomial logistic regression models were fitted, adjusting for covariates.

Results: A total of 430,645 participants were included; mean age was 47.2 (±0.09 SE) years, 31% had HTN, and 49% were male. Mean (SE) sleep disturbance score was 2.8 (0.01); mild sleep disturbance was observed in 21%, moderate in 33%, severe in 13%, and very severe in 33%. In the fully adjusted model, the odds of moderate (adjusted odds ratio (aOR): 1.30; 95% Confidence Intervals, 95%CI: [1.15,1.47]) and severe sleep disturbances (aOR: 1.42; 95%CI: [1.30,1.56]) were 30% and 42%, respectively, higher in persons with HTN compared to those without HTN.

Conclusion: Adults with self-reported HTN are more likely to have higher sleep disturbances, hence, HTN may play a larger role in sleep outcomes. Healthcare professionals play a critical role in assessing sleep patterns and their adverse effects on patients, especially those with HTN and other risk factors for CVD. Further research is needed to explore environmental and other factors contributing to sleep disturbances among adults with HTN, ultimately guiding targeted interventions and improving overall health outcomes.

Notes

References:

Members WC, Virani SS, Newby LK, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2023;82(9):833-955.

Martin SS, Aday AW, Allen NB, et al. 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation. 2025/02/25 2025;151(8):e41-e660.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2018;71(19):e127-e248.

Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Hypertension.0(0).

Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146(5):e18-e43.

Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of cardiology. 2019;74(10):e177-e232.

Description

Suboptimal sleep is recognized as a cardiovascular risk factor, and adults with hypertension experience more sleep disturbances than those without the condition. Incorporating sleep health into comprehensive hypertension management may help reduce adverse health outcomes.

Author Details

Diana-Lyn Baptiste, DNP, RN, FPCNA, FAAN, FRCN; Ruth-Alma Turkson-Ocran, PhD, MPH, APRN, FNP-BC, CNE, FAHA; Binu Koirala, PhD, MGS, RN, FAAN, FPCNA, FAHA; Brenda Owusu, DNP, APRN, ANP-BC, FNP-BC; Oluwabunmi Ogungbe, PhD, MPH, RN, FAAN, FAHA; Stephanie Meng Yuan, MHS; Sabianca Delva, PhD, RN; Marion Botchway, PhD, MPH, CHES; Deandra Romain, MD; Serina Gbaba, DNP, RN, MBA, FNP-C; Faith Elise Metlock, PhD, RN; Yvonne Commodore-Mensah, PhD, RN, MHS, FPCNA, FAHA, FAAN; Cheryl Himmelfarb, PhD, RN, FAAN, FAHA

Sigma Membership

Nu Beta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Acute Care, Sleep Duration, Sleep Quality, Hypertension, Cardiovascular Diseases

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-22

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Exploring the Association Between Hypertension and Sleep Disturbances Among Adults

Toronto, Ontario, Canada

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States (US), contributing to one in three deaths. It is estimated that more than 120 million Americans are living with at least one form of CVD, which include hypertension (HTN). HTN accounts for the highest prevalence, impacting over 50% of individuals aged ≥20 years old in the US. Suboptimal sleep also represents a notable CVD risk factor and has been identified as a contributor to various CVD-related issues. The inclusion of sleep health as one of the Life’s Essential 8 measures in 2022 reinforces its importance for overall well-being and underscores its significance in the prevention of CV. Suboptimal sleep is a risk factor HTN and CVD. However, the association between sleep disturbances and HTN among US adults is unclear.

Objective: To examine the relationship between HTN and sleep disturbances among adults in the U.S. We hypothesized that individuals diagnosed with HTN were more likely to have higher sleep disturbance scores.

Methods: We used a cross-sectional design to examine data from the 2013-2018 National Health Interview Survey. We computed a sleep disturbance score, composite of five components of suboptimal sleep: sleep duration, trouble falling asleep, staying asleep, sleep medication use, and restful sleep. Survey-weighted multinomial logistic regression models were fitted, adjusting for covariates.

Results: A total of 430,645 participants were included; mean age was 47.2 (±0.09 SE) years, 31% had HTN, and 49% were male. Mean (SE) sleep disturbance score was 2.8 (0.01); mild sleep disturbance was observed in 21%, moderate in 33%, severe in 13%, and very severe in 33%. In the fully adjusted model, the odds of moderate (adjusted odds ratio (aOR): 1.30; 95% Confidence Intervals, 95%CI: [1.15,1.47]) and severe sleep disturbances (aOR: 1.42; 95%CI: [1.30,1.56]) were 30% and 42%, respectively, higher in persons with HTN compared to those without HTN.

Conclusion: Adults with self-reported HTN are more likely to have higher sleep disturbances, hence, HTN may play a larger role in sleep outcomes. Healthcare professionals play a critical role in assessing sleep patterns and their adverse effects on patients, especially those with HTN and other risk factors for CVD. Further research is needed to explore environmental and other factors contributing to sleep disturbances among adults with HTN, ultimately guiding targeted interventions and improving overall health outcomes.