0144 Identification of sleep factors related to blood pressure in emergency medicine healthcare workers. (25th May 2022)

• Record Type: Journal Article
• Authors: Belloir, Joseph; Firew, Tsion; Miranda, Maody; Shaw, Kaitlin; Schwartz, Joseph; Makarem, Nour; Marcon, Kathryn; Schultebraucks, Katharina; Sullivan, Alexandra; Chang, Bernard; Shechter, Ari
• Is Part Of: Sleep. Volume 45(2022)Supplement 1
• Page Start: A64
• Page End: A66
• Publication Date: 2022-05-25
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsac079.142
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Emergency Department (ED) healthcare workers (HCWs) may be at elevated risk for the development of cardiovascular disease (CVD), due in part to sleep and/or circadian disturbances. This study aimed to evaluate the relationship of sleep factors with blood pressure, a primary marker of CVD risk, in ED HCWs. Methods: Participants were HCWs (physicians, nurses, advanced practice providers, technicians, etc.) from 4 EDs in New York City who completed study procedures between November 2020-October 2021. Participants completed a 2-week data burst, which included sleep/activity (Fitbit Inspire) and home blood pressure monitoring (Omron 5 Series BP7250; preceding and following their main daily sleep episode). Linear regression models, adjusted for age, gender, and race/ethnicity, were conducted predicting blood pressure from sleep factors. Results: The sample included n=74 ED HCWs (mean [SD] age=38.4 [8.7] years). Most were female (62.2%) and non-Hispanic/Latino White (55.6%). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 116.1 (12.5) mmHg and 75.1 (7.6) mmHg, respectively. Actigraphy-derived sleep factor means for the data burst period were: a) Total sleep time (TST): 6.8 (1.0) hours; b) Sleep efficiency (SE): 94.5 (2.2)%; c) Percentage of main sleep episodes throughout the burst with TST <6 hours: 25.9 (20.8)%; d) Sleep start time: 24:06 (01:24); and e) Within-subject inter-daily bedtime variability (i.e., SD of sleep start times): 2.4 (1.8) hours. Higher TST was associated with lower SBP (B [SE] =-0.50 [0.30] mmHg/10 min, p=.04) and DBP (B [SE] =-0.50 [0.20] mmHg/10 min, p=.01). Greater SE was associated with lower SBP (B [SE] =-1.23 [0.55], mmHg/%, p=.03) and DBP (B [SE] =-1.05 [0.39], mmHg/%, p=.01). A higher proportion of nights with TST <6 hours was associated with higher DBP (B [SE] =1.4 [0.40], mmHg/10%, p<0.01) but not SBP. Sleep start time and bedtime variability were not associated with BP. Conclusion: These findings provide support for the relationship between sleep and blood pressure. Of note, data were collected during the COVID-19 pandemic, which may impact observed relationships. Because this is a cross-sectional analysis, the causal direction of the association may be (at least partially) reversed. Further research should examine psychological and work-related factors in ED HCWs that may modify these relationships, e.g., stress/anxiety, burnout, and job strain, and include assessments of the circadian system. Support (If Any): R01HL146911