What should we tell our worried patients with insomnia about blood pressure?

In this issue of Sleep Medicine Reviews, Jarrin and colleagues [1] report on a systematic review of the cross-sectional and longitudinal association between insomnia, hypertension and abnormal blood pressure (BP) levels across 64 studies comprised of 26 to 162,121 adults ages 18-100 years old. The authors' criteria allowed for the inclusion of studies with different designs (e.g., epidemiologic, case-control), comorbid conditions, and definitions of insomnia or hypertension. This systematic review is timely and very much needed, given that only one meta-analysis had been published to date on the increased risk of incident hypertension associated with any form of insomnia [2]; however, it did not allow for disentangling the critical issues discussed by previous investigators [3-5] such as the definition of insomnia, its chronicity, its objective severity, the measurement of BP and definition of hypertension, and the presence of important confounders in previous studies [e.g., sleep disordered breathing (SDB)].

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