Association Between Sleep Microstructure and Incident Hypertension in a Population-Based Sample: The HypnoLaus Study

Mathieu Berger, Andrew Vakulin, Camila Hirotsu, Nicola Andrea Marchi, Geoffroy Solelhac, Virginie Bayon, Francesca Siclari, José Haba-Rubio, Julien Vaucher, Peter Vollenweider, Pedro Marques-Vidal, Bastien Lechat, Peter G. Catcheside, Danny J. Eckert, Robert J. Adams, Sarah Appleton, Raphael Heinzer

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


BACKGROUND: Poor sleep quality is associated with increased incident hypertension. However, few studies have investigated the impact of objective sleep structure parameters on hypertension. This study investigated the association between sleep macrostructural and microstructural parameters and incident hypertension in a middle-to older-aged sample. METHODS AND RESULTS: Participants from the HypnoLaus population-based cohort without hypertension at baseline were included. Participants had at-home polysomnography at baseline, allowing assessment of sleep macrostructure (nonrapid eye movement sleep stages 1, 2, and 3; rapid eye movement sleep stages; and total sleep time) and microstructure including power spectral density of electroencephalogram in nonrapid eye movement sleep and spindles characteristics (density, duration, frequency, amplitude) in nonrapid eye movement sleep stage 2. Associations between sleep macrostructure and microstructure parameters at baseline and incident clinical hypertension over a mean follow-up of 5.2 years were assessed with multiple-adjusted logistic regression. A total of 1172 participants (42% men; age 55±10 years) were included. Of these, 198 (17%) developed hypertension. After adjustment for confounders, no sleep macrostructure features were associated with incident hypertension. However, low absolute delta and sigma power were significantly associated with incident hypertension where participants in the lowest quartile of delta and sigma had a 1.69-fold (95% CI, 1.00– 2.89) and 1.72-fold (95% CI, 1.05– 2.82) increased risk of incident hypertension, respectively, versus those in the highest quartile. Lower spindle density (odds ratio, 0.87; 95% CI, 0.76– 0.99) and amplitude (odds ratio, 0.98; 95% CI, 0.95–1.00) were also associated with higher incident hypertension. CONCLUSIONS: Sleep microstructure is associated with incident hypertension. Slow-wave activity and sleep spindles, 2 hall-marks of objective sleep continuity and quality, were inversely and consistently associated with incident hypertension. This supports the protective role of sleep continuity in the development of hypertension.

Original languageEnglish
Article numbere025828
JournalJournal of the American Heart Association
Issue number14
Publication statusPublished or Issued - 19 Jul 2022
Externally publishedYes


  • delta power
  • hypertension
  • power spectral density
  • sleep architecture
  • sleep structure
  • slow wave sleep
  • spindle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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