0970 Relationship of Sleep and Sleep Disordered Breathing with Blood Pressure Dipping During Sleep: Preliminary Findings from the SANAR Study

Abstract Introduction Non-dipping blood pressure during sleep (NDBP) could influence the effect of sleep duration, sleep disturbances and sleep-disordered breathing (SDB) on adverse health outcomes. NDBP has been insufficiently studied in Hispanic/Latino populations which have a large burden of SDB and sleep disturbances. Here, we aim to examine the associations between SDB, sleep duration and sleep disturbances with systolic and diastolic blood pressure (BP) dipping using preliminary data from the Hispanic Community Health Study/Study of Latinos. Methods We obtained 24-hour ambulatory blood pressure (BP) monitoring, self-reported validated sleep questionnaires and type-3 sleep apnea studies in 1,434 Hispanic/Latino participants (age ≥50 years). BP dipping was defined as the % decrease in mean systolic or diastolic BP during the sleep period. BP dipping categories were classified as excessive (>20%), preserved (10-20%), blunted/absent (0-10%), or paradoxical (< 0%). We used multinomial logit models to examine the associations of SDB, and sleep disturbances, with the BP dipping categories of preserved (reference), excessive, and blunted/absent and paradoxical dipping. Primary exposures were self-reported sleep duration categories of < 7, 7< 9 (reference), >9 hours. Insomnia (Women’s Health Initiative Insomnia Rating scale- absent: < 9, present: ≥9), sleepiness (Epworth sleepiness scale- non-excessive: < 10, excessive daytime sleepiness: ≥10), and respiratory-event index REI3%: no SDB: < 5 [reference], mild: 5-< 15, moderate:15-< 30, severe: ≥30. Covariates included sex, age, BMI, and maximum systolic or diastolic BP in clinic. Results The sample was two-thirds female with mean age 67.5±6.4 years and mean BMI 30.1±5.6 kg/m2. In adjusted models, long sleep and sleepiness were associated increased relative risk ratios (RRR) for blunted/absent (BA) (BA: RRR9+hrs= 1.12, RRRrei15-< 30=1.16 and RRRREI30+=1.16; and paradoxical (P) P: RRR9+hrs= 1.38, RRRAHI15-< 30=1.35, RRRAHI30+=1.31, and RRRExcessiveESS=1.55) systolic dipping; as well as diastolic dipping (AB): RRR9+hrs= 1.12, RRRAHI15-< 30=1.29; (P): RRR9+hrs= 1.86, RRRsleepiness=1.80) vs. preserved dipping. Wide confidence intervals reflect the preliminary nature of the data and limited statistical power. Conclusion Long sleep duration, excessive daytime sleepiness, and SDB were associated with NDBP, suggesting a potential strategy to reduce adverse health outcomes. Support (if any) NIA R01AG063868, NCATS K12TR004555