Multidimensional sleep health and resting blood pressure in young adults: the role of negative affect

Poor sleep is increasingly recognized as a behavioral risk factor for cardiovascular disease. Few studies have examined how multidimensional sleep health and negative affect jointly relate to blood pressure (BP) in young adults. This study examined sleep health in relation to resting BP and tested whether negative affect accounted for or moderated the association. Participants were 129 young adults (mean age = 19.2 years, 70.5% female) without diagnosed sleep disorders. Sleep health was assessed using a composite index derived from actigraphy (regularity, timing, efficiency, duration) and self-report (satisfaction, alertness) metrics. Resting BP was measured in the laboratory. Hierarchical linear regression models were adjusted for demographics, body mass index, and attitudes toward sleep. Indicators of negative affect (depressive symptoms, anxiety, and hostility) were also included as covariates and tested as moderators. Better sleep health was associated with lower systolic BP only after adjusting for indicators of negative affect (B = - 1.40, SE = 0.63, p = .03). Hostility moderated associations between sleep health and systolic BP, such that effects were only significant among participants lower in hostility. These findings identify sleep health as a potential modifiable risk factor for hypertension and highlight the importance of considering both psychosocial context and multiple sleep dimensions when evaluating cardiovascular risk in early adulthood.