Associations of #Sleep Disordered #Breathing and Insomnia with Incident #Hypertension and #Diabetes: The Hispanic Community Health Study/Study of Latinos

Rationale: Sleep disorders are associated with hypertension and diabetes, primary risk factors for cardiovascular diseases and mortality. It is important to understand these associations in Hispanics/Latinos, in whom cardiovascular death is the leading cause of mortality.

Objectives: To investigate the prospective associations of sleep disordered breathing (SDB) and insomnia with incident hypertension and diabetes among US Hispanics/Latinos over 6 years of follow-up and to assess potential gender differences in these associations. Methods: Data from 11,623 Hispanic/Latino participants in the Hispanic Community Health Study/Study of Latinos (Visit 1: 2008-2011; Visit 2: 2014-2017) were analyzed using survey logistic regression models, adjusting for potential confounders. Measurements and Main Results: SDB (apnea-hypopnea index ≥ 5) and insomnia (Women’s Health Initiative Insomnia Rating Scale ≥ 9) were measured at baseline.

Incident hypertension (≥ Stage 2) and diabetes were defined according to national guidelines. In the target population, 52.6% were female with mean age 41.1 ± 14.9 years at baseline. SDB was associated with a 1.54 higher adjusted odds of incident hypertension (95% confidence interval (CI) [1.18, 2.00]) and 1.37 higher odds of incident diabetes (95% CI [1.07, 1.75]) compared to no SDB. Insomnia was associated with incident hypertension (Odds Ratio (OR) = 1.37; 95% CI [1.11, 1.69]), but not diabetes. The association between insomnia and incident hypertension was stronger among men than women.

Conclusions: SDB was associated with incident hypertension and diabetes. Insomnia was associated with incident hypertension. These findings support the importance of sleep disorders as modifiable targets for disease prevention and reduction.