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Objective <p>Obstructive sleep apnea (OSA) is a recognized risk factor for hypertension, contributing to cardiovascular disease through mechanisms like nocturnal hypoxia and sympathetic dysfunction. The role of bedtime habits in OSA-associated hypertension remains underexplored. This study investigates the association between bedtime habits and hypertension in OSA patients.</p> Methods <p>A cross-sectional study analyzed baseline data from 6,193 community-dwelling adults in Guangdong Province, China, were analyzed. Sleep behavior habits and quality were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Self-reported bedtime was categorized as early (≤ 21:59), moderate (22:00–23:59), or late (≥ 00:00). OSA was diagnosed using a Type IV wearable intelligent sleep monitor. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or self-reported hypertension history.</p> Result <p>OSA was present in 2,660 participants (42.9%). Among individuals with OSA, hypertension prevalence was 56.6% in early bedtimes, 36.9% in moderate bedtimes, and 30.7% in late bedtimes (<i>P</i> &lt; 0.001). In the fully adjusted model, moderate bedtime (OR 0.64, 95% CI 0.48–0.86) and late bedtime (OR 0.67, 95% CI 0.47–0.95) were associated with lower odds of prevalent hypertension compared with early bedtime (reference). Early bedtime remained associated with longer sleep latency, lower sleep efficiency, and higher Pittsburgh Sleep Quality Index and Insomnia Severity Index scores (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Early bedtime (≤ 21:59) was independently associated with higher odds of comorbid hypertension in adults with OSA, while moderate and late bedtimes were associated with lower odds after comprehensive adjustment. Bedtime represents a volitional lifestyle behavior that may be targeted for cardiovascular risk reduction in OSA.</p>

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Association of bedtime with co-morbid hypertension in OSA: a community-based study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月19日

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  • Ruohan Zhou,
  • Guangliang Shan,
  • Yaoda Hu,
  • Tong Feng,
  • Miaochan Lao,
  • Ranxu Zhang,
  • Shuhe Wu,
  • Junzhi Chen,
  • Qiong Ou

摘要

Objective

Obstructive sleep apnea (OSA) is a recognized risk factor for hypertension, contributing to cardiovascular disease through mechanisms like nocturnal hypoxia and sympathetic dysfunction. The role of bedtime habits in OSA-associated hypertension remains underexplored. This study investigates the association between bedtime habits and hypertension in OSA patients.

Methods

A cross-sectional study analyzed baseline data from 6,193 community-dwelling adults in Guangdong Province, China, were analyzed. Sleep behavior habits and quality were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Self-reported bedtime was categorized as early (≤ 21:59), moderate (22:00–23:59), or late (≥ 00:00). OSA was diagnosed using a Type IV wearable intelligent sleep monitor. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or self-reported hypertension history.

Result

OSA was present in 2,660 participants (42.9%). Among individuals with OSA, hypertension prevalence was 56.6% in early bedtimes, 36.9% in moderate bedtimes, and 30.7% in late bedtimes (P < 0.001). In the fully adjusted model, moderate bedtime (OR 0.64, 95% CI 0.48–0.86) and late bedtime (OR 0.67, 95% CI 0.47–0.95) were associated with lower odds of prevalent hypertension compared with early bedtime (reference). Early bedtime remained associated with longer sleep latency, lower sleep efficiency, and higher Pittsburgh Sleep Quality Index and Insomnia Severity Index scores (all P < 0.05).

Conclusion

Early bedtime (≤ 21:59) was independently associated with higher odds of comorbid hypertension in adults with OSA, while moderate and late bedtimes were associated with lower odds after comprehensive adjustment. Bedtime represents a volitional lifestyle behavior that may be targeted for cardiovascular risk reduction in OSA.