Experimentally induced sleep deprivation can raise blood pressure (BP) and worsen hypertension. We recently reported a significantly higher prevalence of obstructive sleep apnea (OSA) and reduced rapid eye movement (REM) sleep time in drug-resistant hypertensives compared to controlled hypertensives.

The objective of this study was to test the hypothesis that short sleep duration is associated with resistant hypertension (RH) independently of OSA, which can itself disrupt and shorten sleep.

In a case–control study, overnight polysomnographic results of subjects with OSA and RH (n = 62) were compared to those with OSA of equal severity and either controlled hypertension (CH) (n = 49) or normotension (n = 40).

Subjects with RH slept 33.8 min (P = 0.02) and 37.2 min (P = 0.02) less than those with CH and normotension, respectively. Consequently, sleep efficiency was reduced by 7.9% (P = 0.007) and 10.2% (P = 0.002), respectively.

They also spent 9.7 min (P = 0.06) and 11.6 min (P = 0.04) less time in REM sleep compared to those with CH and normotension, respectively.

Older age, greater body mass index (BMI) and greater apnea–hypopnea index (AHI) were also associated with shorter sleep time (P = 0.02, P = 0.001, and P = 0.03, respectively) and reduced sleep efficiency (P = 0.0003, P = 0.03, and P = 0.01, respectively).

Our study demonstrates that, compared to subjects with CH or normotension, those with RH have shorter total and REM sleep times and lower sleep efficiency independently of OSA. These data suggest that reduced sleep time may contribute to the severity of hypertension.

American Journal of Hypertension 2010;

23 2, 174–179. doi:10.1038/ajh.2009.220

Oded Friedman^1,2, T. Douglas Bradley^2,3,4, Pimon Ruttanaumpawan² and Alexander G. Logan^1,2

• ^{1Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute of the Mount Sinai Hospital, Toronto, Ontario, Canada}
• ^{2Department of Medicine of the Mount Sinai Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada}
• ^{3Sleep Research Laboratory of the Toronto Rehabilitation Institute, Toronto, Ontario, Canada}
• ^{4Centre or Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, Ontario, Canada}

Correspondence: Alexander G. Logan, (logan@lunenfeld.ca)