Effects of a behavioral sleep extension intervention on cardiometabolic risk factors among patients with elevated BP/hypertension

PROJECT SUMMARY/ABSTRACT
One in two adults in the U.S. have at least one cardiometabolic disease (CMD) including hypertension, heart
disease diabetes or stroke. Despite links between short sleep duration and cardiometabolic health, few
studies have sought to improve CMD risk by extending sleep. A promising area of research is sleep extension
interventions. To date, several small studies have demonstrated short term improvements in sleep and CMD
risk factors such as blood pressure and glycemic control. However, these studies are limited by their short
term design and viewing sleep extension as an experimental manipulation rather than a sustainable behavior
change. In this study, we are proposing to conduct a randomized controlled trial to test our behavioral sleep
extension intervention compared to a health education control group on sleep and CMD risk factors among
adults with prehypertension/stage I hypertension. The sleep extension intervention is based on 3 well
established behavior change principles: self-monitoring (wearable sleep tracker), education (email content)
and motivational enhancement (brief telephone coaching). During this 12 month study, we will include an
intervention period (weeks 1-8, weekly intervention), maintenance period (months 2-6, monthly intervention)
and follow-up period (no intervention). The primary outcome for this study will be sleep duration and the main
secondary outcome will be 24-h ambulatory blood pressure monitoring, which allows us to evaluate both
daytime and nighttime blood pressures in daily life. The evaluation of sleep duration changes of 12-months
will allow us to test the efficacy of our behavioral sleep extension intervention on acute and sustained
changes in sleep duration and CMD risk factors as well as important psychological, behavioral and
physiological mediators such as self-reported sleepiness, BMI, diet, physical activity, glycemic control and
inflammation. Successful completion of this study will provide critical information about the impact of
behavioral sleep extension on important measures of health and quality of life needed to incorporate sleep
extension into CMD risk interventions, such as diet and physical activity programs. The long-term goal of this
research is to develop, test and disseminate effective and scalable sleep interventions to reduce chronic
disease risk and improve disease management.

Grant Number: 5R01NR018891-05
NIH Institute/Center: NIH
Principal Investigator: Kelly Baron