Sleep, Blood Pressure and Vascular Health

University of Colorado, Boulder107 enrolled

Overview

The investigators hypothesize that chronic insufficient sleep is associated with diminished endothelium-dependent nitric oxide-mediated vasodilation and endothelial tissue-type plasminogen activator release in adults with elevated blood pressure. Furthermore, the investigators hypothesize that the postulated diminishment in endothelial vasodilator and fibrinolytic function with insufficient sleep will be due, at least in part, to increased oxidative stress. Furthermore, increasing sleep duration and improving sleep quality will increase both endothelium-dependent nitric oxide-mediated vasodilation and endothelial tissue-type plasminogen activator release in adults with elevated blood pressure. Increases in endothelial vasodilator and fibrinolytic function will be due, at least in part, to reduced oxidative stress.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

107

Conditions

Blood Pressure Sleep

Interventions

Eligibility

Sex: ALLMin age: 45 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: Subjects will be men and women of all races and ethnic backgrounds aged 45-65 years. All women will be premenopausal, perimenopausal or post-menopausal not taking hormone replacement therapy. Subjects will be prehypertensive/hypertensive (Stage 1 hypertension) defined as resting systolic blood pressure 125-159 mmHg and/or diastolic blood pressure 75-99 mmHg. Subjects will have no overt signs of disease as assessed by: 1. medical history; 2. physical examination; 3. electrocardiogram and BP at rest and maximal exercise; 4. sedentary as determined from the Stanford Physical Activity Questionnaire (\<35 kcal/wk) and will not have engaged in any program of regular physical activity for at least 6 months prior to the study. 5. Subjects that have a pre-existing diagnosis of obstructive sleep apnea, or are determined to have obstructive sleep apnea based on their sleep disorders screening visit will be allowed in the study, but will not take part in the sleep intervention/post sleep intervention visits. Exclusion Criteria: History of stroke (phone screen and medical record) Peripheral vascular disease (phone screen and medical record) History of anaphylaxis to betadine, lidocaine, iodine Body mass index \> 40 kg/m2 Subjects taking blood pressure-or diabetes related medication Chronic Insomnia (prior or current diagnosis) History of or current psychiatric disorder (e.g., prior or current diagnosis, current BDI-II\>13; BAI\>10) Significant organ system dysfunction/disease (e.g. diabetes, severe pulmonary, kidney disease) History of seizure disorder Pregnant/nursing Positive toxicology screen-(THC, OPI, AMP, COC, PCP, BAR, BZO, MAMP/MDMA upon sleep lab admission)

Outcomes

Primary Outcomes

Phase 1: Systolic Blood Pressure (SBP)

Time frame: SBP will be measured during Phase 1 at the participants week 1 visit.

Phase 2: Systolic Blood Pressure (SBP)

SBP measured following the participants 8 week sleep intervention

Time frame: SBP will be measured during Phase 2 at the participants week 8 visit.

Phase 1: Diastolic Blood Pressure (DBP)

Time frame: DBP will be measured during Phase 1 at the participants week 1 visit.

Phase 2: Diastolic Blood Pressure (DBP)

DBP measured following the participants 8 week sleep intervention

Time frame: DBP wwill be measured during Phase 2 at the participants week 8 visit.

Phase 1: Forearm blood flow (FBF) response to Acetylcholine (ACh)

Time frame: FBF response to ACh will be measured during Phase 1 at the participants visit 3 which is ~3 weeks from their respective start date.

Phase 2: FBF response to Acetylcholine (ACh)

FBF to ACh will be measured following the participants 8 week sleep intervention

Time frame: FBF response to ACh will be measured during Phase 2 at the participants visit 9 which is ~13 weeks from their respective start date.

Phase 1: FBF response to Sodium Nitroprusside (NTP)

Time frame: FBF response to NTP will be measured during Phase 1 at the participants visit 3 which is ~3 weeks from their respective start date.

Phase 2: FBF response to Sodium Nitroprusside (NTP)

FBF to NTP will be measured following the participants 8 week sleep intervention

Time frame: FBF response to NTP will be measured during Phase 2 at the participants visit 9 which is ~13 weeks from their respective start date.

Phase 1: Endothelial t-PA Release in response to Bradykinin (BDK)

Time frame: t-PA release will be measured during Phase 1 at the participants visit 3 which is ~3 weeks from their respective start date.

Phase 2: Endothelial t-PA Release in response to Bradykinin (BDK)

Endothelial t-PA release will be measured following the participants 8 week sleep intervention.

Time frame: t-PA release will be measured during Phase 2 at the participants visit 9 which is ~13 weeks from their respective start date.

Phase 1: FBF response to L-NMMA

Time frame: FBF response to L-NMMA will be measured during Phase 1 at the participants visit 3 which is ~3 weeks from their respective start date.

Phase 2: FBF response to L-NMMA

FBF to L-NMMA will be measured following the participants 8 week sleep intervention.

Time frame: FBF response to L-NMMA will be measured during Phase 2 at the participants visit 9 which is ~13 weeks from their respective start date.

Phase 1: FBF response to ACh+L-NMMA

Time frame: FBF response to ACh+L-NMMA will be measured during Phase 1 at the participants visit 3 which is ~3 weeks from their respective start date.

Phase 2: FBF response to ACh+L-NMMA

FBF to ACh+L-NMMA will be measured following the participants 8 week sleep intervention

Time frame: FBF response to ACh+L-NMMA will be measured during Phase 2 at the participants visit 9 which is ~13 weeks from their respective start date.

Secondary Outcomes

Phase 1: Pittsburgh Sleep Quality Index (PSQI)

This questionnaire assesses sleep quality. Scores range from 0 indicating no difficulty and 21 indicating severe difficulty.

Time frame: The PSQI questionnaire will be administered during Phase 1 at the participants week 1 visit.

Phase 2: PSQI

This questionnaire assesses sleep quality. Scores range from 0 indicating no difficulty and 21 indicating severe difficulty.

Time frame: The PSQI questionnaire will be administered during Phase 2 at the participants week 8 visit.

Phase 1: Insomnia Severity Index

This questionnaire is used to assess the nature and severity of insomnia. Scores range from 0 no insomnia to 28 severe insomnia.

Time frame: The insomnia severity index questionnaire will be administered during Phase 1 at the participants week 1 visit.

Phase 2: Insomnia Severity Index

This questionnaire is used to assess the nature and severity of insomnia. Scores range from 0 no insomnia to 28 severe insomnia.

Time frame: The insomnia severity index questionnaire will be administered during Phase 2 at the participants week 8 visit.

Phase 1: Epworth Sleepiness Scale

This questionnaire is used to assess daytime sleepiness. Scores range from 0 normal daytime sleepiness to 24 severe daytime sleepiness.

Time frame: The Epworth Sleepiness scale questionnaire will be administered during Phase 1 at the participants week 1 visit.

Phase 2: Epworth Sleepiness Scale