Morning blood pressure is associated with sleep quality in obese adolescents

Tamara S. Hannon, Wanzhu Tu, Sara E. Watson, Hasnaa Jalou, Sangeeta Chakravorty, Silva A. Arslanian

Research output: Contribution to journalArticle

17 Scopus citations


Objective To examine relationships among blood pressure (BP), adiposity, and sleep quality with the use of overnight polysomnography in obese adolescents. Study design Overnight polysomnogram and morning BP measurements were performed in obese (body mass index [BMI] >95th percentile) nondiabetic adolescents (eligible age range 12-18 years, n = 49). Subjects were stratified into 2 groups, one with normal BP, and one with elevated BP, and demographic and clinical characteristics were compared between the groups. Multiple linear regression analysis was used to assess the effects of sleep quality on BP. Results Participants (n = 27) had a normal morning BP, and 22 (44.9%) had elevated morning BP. There were no differences in age (P =.53), sex (P =.44), race (P =.58), or BMI (P =.56) between the 2 BP groups. The group with elevated BP spent shorter percentages of time in rapid eye movement (REM; P =.006) and slow-wave sleep (SWS; P =.024). Multiple linear regression analysis showed that a lower percentage of both REM and SWS was associated with increased morning BP after we adjusted for pubertal stage, sex, race, and BMI. Conclusion Lack of deeper stages of sleep, REM sleep, and SWS is associated with greater morning BP in obese adolescents, independent of BMI. Poor sleep quality should be considered in the work-up of obese youth with hypertension. Intervention studies are needed to evaluate whether improving the quality of sleep will decrease BP elevation.

Original languageEnglish (US)
Pages (from-to)313-317
Number of pages5
JournalJournal of Pediatrics
Issue number2
StatePublished - Feb 1 2014


  • AHI
  • Apnea-hypopnea index
  • Blood pressure
  • BMI
  • Body mass index
  • BP
  • DBP
  • Diastolic blood pressure
  • Polysomnogram
  • PSG
  • Rapid eye movement
  • REM
  • Saturation level of oxygen in hemoglobin
  • SBP
  • Slow-wave sleep
  • SpO
  • SWS
  • Systolic blood pressure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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