Association between sleep disturbance and hypertension: Mediation analysis involving Systemic Inflammatory Response Index in the NHANES

Abstract Both hypertension and sleep disturbance have been closely linked to inflammation. However, the specific role of inflammation in the relationship between sleep disturbance and hypertension remains unclear. We investigated the pairwise associations among a novel inflammatory marker (systemic immune inflammation index), sleep disturbance, and hypertension in a powerful, racially diverse sample (n=23,414) from the 2005-2020 National Health and Nutrition Examination Survey (NHANES). We found that participants with high blood pressure and/or sleep disorders had higher levels of SII than those without hypertension or sleep disorders. Sleep disturbance was positively associated with SII and hypertension even after taking into account a wide range of potential confounding factors (e.g., age, sex, body mass index). We found positive associations between SII and the prevalence of hypertension in this cross-sectional study.The SII mediated a marginal portion of the potential effects of sleep disturbance on hypertension. Our research showed that SII, sleep disturbance, and hypertension are related. Increased SII levels slightly mediated the association between sleep disturbance and hypertension.