TY - JOUR
T1 - Effect of behavioural sleep interventions on blood pressure, heart rate and heart rate variability in adults with poor sleep health: a systematic review, meta-analysis and meta-regression analysis
AU - Mostafa, Samiul A
AU - Hanif, Wasim
AU - Balanos, George
AU - Nirantharakumar, Krishnarajah
AU - Ellis, Jason G
AU - Tahrani, Abd A
PY - 2026/1/20
Y1 - 2026/1/20
N2 - BackgroundPoor sleep health is known to negatively impact on cardiovascular risk factors, including systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and heart rate variability (HRV). Consequently, there is interest in determining the impact of improving sleep on cardiovascular risk. We reviewed studies aimed at improving sleep using (1) Cognitive Behavioural Therapy for Insomnia (CBT-I) and/or sleep hygiene and (2) sleep extension on these risk factors.MethodsLiterature searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane Library. Studies featuring adults ≥ 18years, a sleep intervention and pre- and post-risk factor measurements available were included. Studies of obstructive sleep apnoea were excluded.ResultsFrom 21 studies (n = 1222), meta-analyses of 12 RCTs (n = 688), demonstrated a significant reduction in SBP averaging 4.91 mmHg (2.38, 7.43, p < 0.00001, heterogeneity (I2) = 74%), compared to control.When 15 RCTs and non-RCTs were combined (n = 860), reductions in SBP and DBP averaged 5.02 mmHg (95% CI 2.80, 7.23, p < 0.00001, I2 67%) and 2.90 mmHg (0.30, 5.49; p = 0.03, I2 88%) respectively. In eight CBT-I and/or sleep hygiene interventions (n = 618), the SBP decrease averaged 3.44 mmHg (1.07, 5.80, p = 0.004). In sleep extension interventions (n = 242; 7 studies), reductions in SBP averaged 7.59 mmHg (4.74, 10.44; p < 0.00001), DBP 4.83 mmHg (0.73, 8.92; p = 0.02) and HR (n = 164, 4 studies) 1.24 beats/minute (0.44, 2.44; p = 0.04).No significant changes in HRV were observed.Seven studies were of low concern on quality assessment.ConclusionsUsing behavioural sleep interventions led to clinically significant reductions in blood pressure, suggesting addressing poor sleep health could feature in blood pressure management. Future randomised controlled trials are still required.
AB - BackgroundPoor sleep health is known to negatively impact on cardiovascular risk factors, including systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and heart rate variability (HRV). Consequently, there is interest in determining the impact of improving sleep on cardiovascular risk. We reviewed studies aimed at improving sleep using (1) Cognitive Behavioural Therapy for Insomnia (CBT-I) and/or sleep hygiene and (2) sleep extension on these risk factors.MethodsLiterature searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane Library. Studies featuring adults ≥ 18years, a sleep intervention and pre- and post-risk factor measurements available were included. Studies of obstructive sleep apnoea were excluded.ResultsFrom 21 studies (n = 1222), meta-analyses of 12 RCTs (n = 688), demonstrated a significant reduction in SBP averaging 4.91 mmHg (2.38, 7.43, p < 0.00001, heterogeneity (I2) = 74%), compared to control.When 15 RCTs and non-RCTs were combined (n = 860), reductions in SBP and DBP averaged 5.02 mmHg (95% CI 2.80, 7.23, p < 0.00001, I2 67%) and 2.90 mmHg (0.30, 5.49; p = 0.03, I2 88%) respectively. In eight CBT-I and/or sleep hygiene interventions (n = 618), the SBP decrease averaged 3.44 mmHg (1.07, 5.80, p = 0.004). In sleep extension interventions (n = 242; 7 studies), reductions in SBP averaged 7.59 mmHg (4.74, 10.44; p < 0.00001), DBP 4.83 mmHg (0.73, 8.92; p = 0.02) and HR (n = 164, 4 studies) 1.24 beats/minute (0.44, 2.44; p = 0.04).No significant changes in HRV were observed.Seven studies were of low concern on quality assessment.ConclusionsUsing behavioural sleep interventions led to clinically significant reductions in blood pressure, suggesting addressing poor sleep health could feature in blood pressure management. Future randomised controlled trials are still required.
KW - sleep disorder
KW - intervention
KW - blood pressure
KW - heart rate
KW - systematic review and meta-analysis
U2 - 10.1093/ehjopen/oeag006
DO - 10.1093/ehjopen/oeag006
M3 - Article
SN - 2752-4191
JO - European Heart Journal Open
JF - European Heart Journal Open
M1 - oeag006
ER -