0393 Insomnia with Short Sleep Duration Is Associated with Hypertension and Endothelial Dysfunction in Young Adults

Abstract Introduction Prior studies have examined the association between insomnia with short sleep duration (ISSD) with hypertension in middle-aged adults. However, no study to date has examined its association with elevated blood pressure (eBP) and flow-mediated dilation (FMD) in young adults. Methods We studied 270 young adults (median 25y, 53% female, 24% racial/ethnic minority) from the Penn State Child Cohort who underwent a 9-hour polysomnography (PSG) recording and Doppler ultrasound to asses FMD. The average of three consecutive BP readings was used to calculate resting mean arterial pressure (MAP) in the evening and morning. eBP was defined as systolic BP ≥120 mmHg, diastolic BP ≥80 mmHg, hypertension diagnosis, and/or antihypertensive medication use. Insomnia symptoms were defined as difficulties initiating or maintaining sleep, insomnia diagnosis or complaint, and/or sleep medication use. PSG-measured short sleep duration was defined by the median of the sample (i.e., < 7-h), identifying normal sleep duration (NSD), short sleep duration (SSD), insomnia with normal sleep duration (INSD) and ISSD. Multivariate general linear models tested mean differences in MAP and FMD across the four groups adjusting for sex, race/ethnicity, age, waist circumference, sleep apnea, cardiometabolic disorders, substance and medication use. A logistic regression model examined the association of the four groups with the presence of eBP, while accounting for the same covariables. Results Compared to NSD (84.6±1.2) or INSD (85.7±0.8), ISSD showed significantly higher evening MAP levels (88.0±0.8; p=0.022 and p=0.044, respectively), a finding replicated by morning MAP levels. Neither INSD (p=0.466) nor SSD (86.9±1.3; p=0.190) showed significantly elevated MAP levels compared to NSD. Similarly, ISSD (9.4±0.5; p=0.012), but not INSD (10.3±0.5; p=0.170) or SSD (10.3±0.7; p=0.257), showed significantly lower FMD levels compared to NSD (11.4±0.6). The odds of eBP were significantly increased in ISSD (OR=2.5, 95%CI=1.0-6.2; p=0.044), but not in INSD (OR=1.7, 95%CI=0.7-4.3; p=0.244) or SSD (OR=1.4, 95%CI=0.5-4.1; p=0.580), compared to NSD. Conclusion ISSD, but not INSD, is associated with hypertension and endothelial dysfunction in young adults. Clinical trials should examine whether improving insomnia symptoms and lengthening objective sleep duration in this phenotype may lead to favorable cardiovascular outcomes. Support (if any) NIH (R01HL136587, R01MH118308, UL1TR00127)