1000 Effects of a Behavioral Sleep Extension Intervention on Sleep, Patient Reported Outcomes and Cardiometabolic Health Outcomes over 12 Months

Abstract Introduction The goal of this study was to test the effects of an 8-week behavioral sleep extension intervention among adults with elevated blood pressure and objective sleep duration < 7 hours per night. Methods Adults ages 18+ with sleep duration < 7 hours documented using 7 nights of actigraphy and resting clinic blood pressure >120/80-150/90 mmHg, were randomized to an 8 weeks of brief telephone coaching, a Fitbit and sleep-focused educational content versus health education and a brief weekly phone call to confirm receipt of information. The intervention was followed by a 2-month maintenance period of monthly educational materials focused on sleep vs. general health education and monthly phone/email contact. Participants completed assessments as 8 weeks, 6 months and 12 months consisting of actigraphy, 24h ambulatory blood pressure monitoring (ABPM), cardiometabolic testing (BMI, body fat, HbA1c, triglycerides, cholesterol, and high sensitivity CRP (hsCRP). Data were analyzed using mixed models controlling for age, race and ethnicity. Results The study included 120 participants, 60 sleep extension (age m=42.2, sd=11.3, n=25 females) and 60 health education (age m=41.0, sd=10.2, n=23 females). The intervention group demonstrated a greater change in sleep duration at 8 weeks and maintained their sleep duration at 12 months but the difference between groups was not significant. There was not a significance difference between the groups in sleep duration at 6 months or 12 months or for other actigraphy measures. The intervention group demonstrated greater improvement in depression scores but there were no other significant changes in self-reported sleep quality, sleep related impairment or perceived stress. There was a reduction in 24h SBP and DBP at 8 weeks and 6 months in the control group but no change in the intervention group. The intervention group demonstrated decreases in triglycerides and VLDL at 8 weeks and 6 months. No other changes in cardiometabolic outcomes were observed. Conclusion Results demonstrate a behavioral sleep extension led to increased sleep duration and improved mood during the coaching period, but few improvements in cardiometabolic health. Future research is needed to understand variability in sleep outcomes and techniques to maintain changes over time. Support (if any) R01NR018891