Sleeping well may curb hypertension risk in teens

Meeting the recommended hours of sleep per night appears to put adolescents at lower risk of hypertension, according to a study.

Analysis of data from the Adolescent Brain Cognitive Development (ABCD) study showed that adolescents with healthy sleep patterns (9–12 hours/night) had significantly lower risk of hypertension compared with those who had low healthy sleep (≥2 hours below or above optimal), with a relative risk reduction of 37 percent (relative risk, 0.63, 95 percent confidence interval [CI], 0.25–0.82; p<0.05). [J Am Heart Assoc 2024;doi:10.1161/JAHA.124.03750]

“The finding aligns with previous research linking adequate sleep duration and quality to better cardiovascular outcomes,” the investigators said. [Child Care Health Dev 2024;50:e13273; Ment Health Phys Act 2024;27:100611]

Meanwhile, no association was found between neighbourhood noise and hypertension risk, suggesting that while environmental noise may disrupt sleep, adolescents may be less susceptible to the direct effect of sleep disturbance on blood pressure (BP), they added. [Sleep Adv 2022;3:zpac001]

“It is possible that adolescents are more resilient to noise‐induced stress or that other environmental factors, such as indoor air quality or physical activity levels, play a more dominant role in influencing BP,” the investigators noted. [J Pediatr 2013;165:1046.e2-1049.e2]

The analysis included 3,320 ABCD study participants (mean age at follow-up 13.9 years, 47.6 percent girls, 52.9 percent White) who had complete data on Fitbit‐tracked sleep, BP, height, neighbourhood noise, and covariates (biological sex, race and ethnicity, pubertal stage, waist circumference).

The prevalence of hypertension increased from 1.7 percent (95 percent CI, 1.4–2.1) at baseline (2018–2020) to 2.9 percent (95 percent CI, 2.4–3.6) over the 2‐year follow-up period (2020–2022). The average night noise level was 58.4 dB. The number of participants with healthy sleep, decreased from 29.9 percent at baseline to 20.3 percent at follow-up.

Enhancing sleep quality

Overall, the present data highlight the importance of promoting good sleep hygiene practices to mitigate hypertension risk in adolescents, according to the investigators.

“Improving adolescent sleep quality is crucial and clinically relevant… Several factors related to poor sleep quality that can be addressed to enhance adolescent sleep health [include] high screen time before bed, irregular sleep schedules, and poor sleep environments,” they said.

The investigators mentioned that aside from reducing screen time, promoting consistent sleep schedules, and optimizing the sleep environment, sleep quality may be improved by engaging in regular physical activity and managing stress through mindfulness and cognitive–behavioural techniques. [JAMA Pediatr 2016;170:1202-1208; Sleep Med Rev 2015;21:50-58; J Adolesc 2009;32:1045-1057; Sleep Med Rev 2016;28:32-45]

“Interventions aimed at extending sleep duration and improving sleep quality [in adolescents] could be a cost‐effective strategy to combat the growing prevalence of hypertension in this age group, as shown in adults,” they added. [Prehosp Emerg Care 2023;27:815-824]