Abstract
OBJECTIVE: This study aimed to examine whether sleep maintenance efficiency (SME) and total sleep time (TST), measured by wristband devices tracking both movement and heart rate patterns, are associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS: This cross-sectional study was conducted using data from 72 individuals who participated in a Japanese municipality's project for improving sleep quality. Fitbit-derived sleep data were linked with health checkup and claims data. Linear regression analyses were conducted with SBP or DBP as the dependent variable, and SME or TST as the independent variable. We constructed simple and multivariable models that adjusted for age, sex, body mass index, smoking, alcohol consumption, exercise habit, restful sleep, and antihypertensive medication use. RESULTS: SBP significantly decreased with higher SME in the simple model (B = -1.92 mmHg, p = 0.01) and the multivariable model (B = -1.87 mmHg, p = 0.02). When SME was analyzed as quartile groups in the multivariable model, the lowest group had a significantly higher SBP (B = 8.51 mmHg, p = 0.04) than the highest group. This negative association was also observed in sensitivity analyses with bootstrapping that focused on participants without antihypertensive medication use and participants with normotensive SBP. SME showed no association with DBP, and TST showed no association with SBP or DBP. CONCLUSION: SME was associated with SBP, whereas TST showed no clear association. Sleep quality assessments using wearable devices may provide useful insights that support the prevention of blood pressure elevation and population health monitoring.