Systemic inflammatory biomarkers as mediators of the association between dietary flavonoids and sleep disorders in patients with hypertension: A population-based study

Dietary flavonoids are beneficial for the management of chronic diseases. This research aimed to investigate the impact of dietary flavonoid intake on sleep disorders in hypertensive patients and to explore the potential mediating effects of systemic inflammatory biomarkers. The cross-sectional study analyzed data from 4538 noninstitutionalized hypertensive patients with sleep disorders from two survey cycles (2007–2008, 2009–2010) of the National Health and Nutritional Examination Survey. The results showed that hesperetin alleviated sleep disorders in hypertensive patients (OR = 0.86, 95 % CI = 0.76 to 0.97; P = 0.037). Additionally, mediation analyses indicated that inflammatory markers mediated a significant portion of the association between dietary hesperetin intake and the risk of sleep disorders in hypertensive patients: CRP (5.31 %, P = 0.008), PAR (12.29 %, P = 0.016), and CAR (1.34 %, P = 0.008). Hesperetin intake positively contributed to improving sleep disorders in hypertensive patients, and this favorable association was partly mediated through improvements in systemic inflammatory markers.