Actigraphy-based sleep analysis in sedentary and overweight/obese adults with primary hypertension: data from the EXERDIET-HTA study
The aim of this study was to analyze actigraphy-based sleep quantity and quality in sedentary and overweight/obese adults with primary hypertension (HTN) divided by sex and cardiorespiratory fitness (CRF) and to assess the association of sleep parameters with body composition, blood pressure (BP), and CRF.
This is a cross-sectional design utilizing data from the EXERDIET-HTA study conducted in 154 non-physically, obese adults with HTN (53.3 ± 7.8 years). Sleep parameters (total bedtime; total sleep time, TST; and sleep efficiency = (TST/total bedtime) × 100)) were calculated from raw accelerometer data (ActiGraph GT3X+). Peak oxygen uptake (V̇O2peak) determined the CRF. Blood pressure was assessed with the 24-h ambulatory BP monitoring. The distributions of V̇O2peak were divided into tertiles (low, medium, and high CRF) in each sex. Series of linear regression analyses were conducted between sleep, fitness, and health-related variables.
Short sleep duration (6.2 h) both on weekdays and weekends, poor sleep quality (< 85% of efficiency), and no significant differences in sleep variables between women and men, nor among CRF groups, were observed. The short sleeping pattern was negatively associated (P < 0.05) with mean and night systolic BP (mmHg, β = − 0.2), and sleep efficiency with waist circumference (cm, β = − 0.08, P = 0.05).
Actigraphy-based sleep analysis reinforces that sleep disorders, such as short sleep duration and poor sleep quality, are associated with high BP and abdominal obesity in sedentary adults with overweight/obesity and HTN. Sleep pattern did not appear to be related with CRF level in this population.
KeywordsActigraphy Ambulatory blood pressure Sleep quantity Sleep quality Cardiorespiratory fitness
Our special thanks to Javier Pérez-Asenjo, the cardiologist who has promoted and taken part in this project with medical assessment. Also, thanks to the Department of Physical Education and Sport and Faculty of Physical Education and Sport-Physical Activity and Sport Sciences Section (University of the Basque Country, UPV/EHU) for believing in our project and providing the material and facilities to start with.
Conceived and designed the experiment: AMAB and SMM. Data collection and analysis: AMAB, SMM, PC, IGA, GRA. Data interpretation and drafting of the manuscript: AMAB, SMM, PC, IGA, IM.
The University of the Basque Country (EHU14/08, PPGA18/15) supported this study and The Basque Government to AMAB, PC and IGA with predoctoral grants.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Calhoun DA, Harding SM (2010) Sleep Hypertens 138:434–443Google Scholar
- 7.Vanhecke TE, Franklin BA, Ajluni SC, Sangal RB, McCullough PA (2008) Cardiorespiratory fitness and sleep-related breathing disorders. 6:745–758Google Scholar
- 11.Full KM, Kerr J, Grandner MA, Malhotra A, Moran K, Godoble S, Natarajan L, Soler X (2018) Validation of a physical activity accelerometer device worn on the hip and wrist against polysomnography. 4:209–216Google Scholar
- 12.Maldonado-Martín S, Gorostegi-Anduaga I, Aispuru G, Illera-Villas M, Jurio-Iriarte B (2016) Effects of different aerobic exercise programs with nutritional intervention in primary hypertensive and overweight/obese adults: EXERDIET-HTA controlled trial. 6:2167–0870.1000252Google Scholar
- 15.Maugeri A, Medina-Inojosa JR, Kunzova S, Agodi A, Barchitta M, Sochor O, Lopez-Jimenez F, Geda YE, Vinciguerra M (2018) Sleep duration and excessive daytime sleepiness are associated with obesity independent of diet and physical activity. Nutrients 10. https://doi.org/10.3390/nu10091219 CrossRefGoogle Scholar
- 16.Gorostegi-Anduaga I, Corres P, Jurio-Iriarte B, Martinez-Aguirre A, Perez-Asenjo J, Aispuru GR, Arenaza L, Romaratezabala E, Arratibel-Imaz I, Mujika I, Francisco-Terreros S, Maldonado-Martin S (2018) Clinical, physical, physiological, and dietary patterns of obese and sedentary adults with primary hypertension characterized by sex and cardiorespiratory fitness: EXERDIET-HTA study. Clin Exp Hypertens 40:141–149. https://doi.org/10.1080/10641963.2017.1346111 CrossRefPubMedGoogle Scholar
- 18.Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KAS, Williamson JD, Wright JT Jr (2017) 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. J Am Coll CardiolGoogle Scholar
- 25.Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, Toplak H, Obesity Management Task Force of the European Association for the Study of Obesity (2015) European guidelines for obesity management in adults. Obes Facts 8:402–424. https://doi.org/10.1159/000442721 CrossRefPubMedPubMedCentralGoogle Scholar