Sleep Loss and Hypertension: A Systematic Review
Laura Palagini, Rosa Maria Bruno, Angelo Gemignani, Chiara Baglioni, Lorenzo Ghiadoni and Dieter Riemann
Affiliation: Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, School of Medicine, University of Pisa, Pisa, Italy, Via Roma, 67, 56126, Pisa, Italy.
Hypertension and insomnia are very common and often coexist. There is evidence to suggest that the increasing prevalence of
arterial hypertension in the past decade might be related both to an increased prevalence of insomnia and to the decline of sleep duration
due to modern lifestyle. The aim of this paper is to reconsider both the clinical evidence of the relationship between conditions of sleep
loss and of perceived impairment in sleep quality with hypertension and the potential pathophysiological mechanisms underlying the biological
plausibility of their relationship. Through a systematic search from MEDLINE, EMBASE, PsychINFO we selected articles, which
reported experimental sleep deprivation designs, or studied sleep duration or insomnia and their relationship with blood pressure or hypertension
in participants over 18 years. This analysis shows that experimental sleep deprivation, short sleep duration, and persistent insomnia
are associated with increased blood pressure and increased risk of hypertension, even after controlling for other risk factors.
Pathophysiological mechanisms underlying this association might be related to inappropriate arousal (“hyperarousal”) due to an overactivation
of stress system functions. According this hypothesis, prolonged sleep loss or alterations of sleep quality might act as a neurobiological
and physiologic stressor that impair brain functions and contribute to allostatic load, compromising stress resilience and somatic
Keywords: Sleep deprivation, short sleep duration, insomnia and hypertension, stress, MEDLINE, EMBASE, PsychINFO, sleep quality, somatic health
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