Abstract 31: Association of Multiple Dimensions of Sleep with Lifespan Trajectories of Blood Pressure from Childhood through Early Adulthood

Abstract

Objective: To investigate whether inadequate sleep confers long-term risk on the lifespan trajectories of blood pressure (BP) levels from childhood through adolescence into young adulthood. Methods: A total of 698 participants from the Penn State Child Cohort underwent in-lab polysomnography (PSG) and seated BP measurements at three visits. At visit 1, subjects were children aged 5-12. At the second visit, 5.8 to 13.0 years later (Md=7.4), 421 of them were adolescents aged 12-19 (90%) or young adults aged 20-23 (10%). At the third visit, 12.3 to 23.8 years later (Md=16.2), 307 of them were young adults aged 20-24 (50%) or early adults aged 25-33 (50%). We used growth mixture models to classify each participant’s systolic (SBP) and diastolic (DBP) age-related trajectory into latent classes; non-linear polynomials were included when testing three- and four-class solutions. We tested the longitudinal association of insomnia symptoms (IS), apnea/hypopnea index (AHI), and total sleep time (TST) with each SBP and DBP trajectory. We adjusted these models for sex, age, race/ethnicity, body mass index, anti-hypertensive medication, periodic limb movements, sleep apnea treatment, and time-to-follow-up. Results: SBP latent classes 1 (57.7%) and 2 (39.4%) followed linear trajectories, while class 3 (2.9%) a quadratic trajectory. DBP latent classes 1 (64.6%) and 4 (2.3%) followed quadratic trajectories, while classes 2 (30.9%) and 3 (2.2%) linear trajectories. IS were associated with 7.1 (3.3) mmHg higher SBP levels in class 3 (p=0.03). AHI was associated with 8.5 (4.0) mmHg higher SBP levels in class 3 (p=0.03) and with 3.0 (1.2) and 5.1 (2.6) mmHg higher DBP in classes 2 (p=0.01) and 4 (p=0.04). TST was associated with 2.0 (0.9) mmHg higher SBP levels in class 1 (p=0.03) and with 9.6 (3.5) mmHg higher DBP levels in class 4 (p=0.01). Conclusion: While inadequate sleep is known to acutely elevate BP levels, this study shows that specific sleep dimensions differentially impact the lifespan trajectories of BP levels as children grow into early adulthood. Early screening and interventions on sleep are warranted in order to prevent adverse cardiovascular outcomes later in life.