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

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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.