Abstract
Objective:
Sleep insufficiency, whether related to quality, timing or duration, is known to negatively impact on blood pressure (BP). Consequently, there has been much interest in determining the impact of improving sleep using sleep interventions on BP. 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 BP.
Design and method:
Literature searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults greater than or equal to 18 years, a sleep intervention with pre- and post-intervention systolic BP (SBP) and diastolic BP (DBP) measurements available. We excluded obstructive sleep apnoea and drug studies. From the extracted data, pooled mean differences were calculated using the inverse variance method and a random effects model.
Results:
Meta-analyses of 15 pilot studies (n=860, study length of 2 weeks to 12 months) demonstrated significant reductions in SBP averaging 5.02mmHg (95% CI 2.80, 7.23, p<0.00001, heterogeneity (I2) 67%) and DBP averaging 2.90mmHg (0.30, 5.49; p=0.03, I2 88%) compared to control.
In eight CBT-I and/or sleep hygiene studies (n=618), the SBP decrease averaged 3.44mmHg (1.07, 5.80, p=0.004, I2 53%), but was not significant for DBP, 1.36mmHg (-1.55, 4.27; p=0.36, I2 85%).
In seven sleep extension studies (n=242), the SBP decrease averaged 7.59mmHg (4.74, 10.44; p<0.00001, I2 43%) and DBP 4.83mmHg (0.73, 8.92; p=0.02, I2 86%).
Studies with mean BP levels in the categories of stage 1 and 2 hypertension at baseline demonstrated higher average reductions in SBP compared to studies with mean BP levels in the normal or elevated BP categories at baseline: stage 2 hypertension, 7.40mmHg (5.00, 9.81, p<0.00001); stage 1 hypertension, 4.98mmHg (1.28, 8.67, p=0.008); elevated BP, 3.18mmHg (-3.79, 10.15, p=0.37) and normal BP, 3.30mmHg (-0.55, 7.15, p=0.09).
Conclusions:
Using sleep interventions led to clinically significant reductions in BP. As both sleep interventions are feasible and efficacious in pilot studies, future research should focus on conducting large scale randomised trials to examine if they can be used as an adjunct to traditional lifestyle interventions of diet and physical activity.
Sleep insufficiency, whether related to quality, timing or duration, is known to negatively impact on blood pressure (BP). Consequently, there has been much interest in determining the impact of improving sleep using sleep interventions on BP. 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 BP.
Design and method:
Literature searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults greater than or equal to 18 years, a sleep intervention with pre- and post-intervention systolic BP (SBP) and diastolic BP (DBP) measurements available. We excluded obstructive sleep apnoea and drug studies. From the extracted data, pooled mean differences were calculated using the inverse variance method and a random effects model.
Results:
Meta-analyses of 15 pilot studies (n=860, study length of 2 weeks to 12 months) demonstrated significant reductions in SBP averaging 5.02mmHg (95% CI 2.80, 7.23, p<0.00001, heterogeneity (I2) 67%) and DBP averaging 2.90mmHg (0.30, 5.49; p=0.03, I2 88%) compared to control.
In eight CBT-I and/or sleep hygiene studies (n=618), the SBP decrease averaged 3.44mmHg (1.07, 5.80, p=0.004, I2 53%), but was not significant for DBP, 1.36mmHg (-1.55, 4.27; p=0.36, I2 85%).
In seven sleep extension studies (n=242), the SBP decrease averaged 7.59mmHg (4.74, 10.44; p<0.00001, I2 43%) and DBP 4.83mmHg (0.73, 8.92; p=0.02, I2 86%).
Studies with mean BP levels in the categories of stage 1 and 2 hypertension at baseline demonstrated higher average reductions in SBP compared to studies with mean BP levels in the normal or elevated BP categories at baseline: stage 2 hypertension, 7.40mmHg (5.00, 9.81, p<0.00001); stage 1 hypertension, 4.98mmHg (1.28, 8.67, p=0.008); elevated BP, 3.18mmHg (-3.79, 10.15, p=0.37) and normal BP, 3.30mmHg (-0.55, 7.15, p=0.09).
Conclusions:
Using sleep interventions led to clinically significant reductions in BP. As both sleep interventions are feasible and efficacious in pilot studies, future research should focus on conducting large scale randomised trials to examine if they can be used as an adjunct to traditional lifestyle interventions of diet and physical activity.
| Original language | English |
|---|---|
| Pages (from-to) | e181-e182 |
| Number of pages | 2 |
| Journal | Journal of Hypertension |
| Volume | 43 |
| Issue number | Suppl 1 |
| DOIs | |
| Publication status | Published - 1 May 2025 |