Actigraphy-based sleep analysis in sedentary and overweight/obese adults with primary hypertension: data from the EXERDIET-HTA study



The aim of this study was to analyze actigraphy-based sleep quantity and quality in sedentary and overweight/obese adults with primary hypertension (HTN) divided by sex and cardiorespiratory fitness (CRF) and to assess the association of sleep parameters with body composition, blood pressure (BP), and CRF.


This is a cross-sectional design utilizing data from the EXERDIET-HTA study conducted in 154 non-physically, obese adults with HTN (53.3 ± 7.8 years). Sleep parameters (total bedtime; total sleep time, TST; and sleep efficiency = (TST/total bedtime) × 100)) were calculated from raw accelerometer data (ActiGraph GT3X+). Peak oxygen uptake (V̇O2peak) determined the CRF. Blood pressure was assessed with the 24-h ambulatory BP monitoring. The distributions of V̇O2peak were divided into tertiles (low, medium, and high CRF) in each sex. Series of linear regression analyses were conducted between sleep, fitness, and health-related variables.


Short sleep duration (6.2 h) both on weekdays and weekends, poor sleep quality (< 85% of efficiency), and no significant differences in sleep variables between women and men, nor among CRF groups, were observed. The short sleeping pattern was negatively associated (P < 0.05) with mean and night systolic BP (mmHg, β = − 0.2), and sleep efficiency with waist circumference (cm, β = − 0.08, P = 0.05).


Actigraphy-based sleep analysis reinforces that sleep disorders, such as short sleep duration and poor sleep quality, are associated with high BP and abdominal obesity in sedentary adults with overweight/obesity and HTN. Sleep pattern did not appear to be related with CRF level in this population.

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Our special thanks to Javier Pérez-Asenjo, the cardiologist who has promoted and taken part in this project with medical assessment. Also, thanks to the Department of Physical Education and Sport and Faculty of Physical Education and Sport-Physical Activity and Sport Sciences Section (University of the Basque Country, UPV/EHU) for believing in our project and providing the material and facilities to start with.


The University of the Basque Country (EHU14/08, PPGA18/15) supported this study and The Basque Government to AMAB, PC and IGA with predoctoral grants.

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Conceived and designed the experiment: AMAB and SMM. Data collection and analysis: AMAB, SMM, PC, IGA, GRA. Data interpretation and drafting of the manuscript: AMAB, SMM, PC, IGA, IM.

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Correspondence to Sara Maldonado-Martín.

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MartinezAguirre-Betolaza, A., Maldonado-Martín, S., Corres, P. et al. Actigraphy-based sleep analysis in sedentary and overweight/obese adults with primary hypertension: data from the EXERDIET-HTA study. Sleep Breath 23, 1265–1273 (2019).

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  • Actigraphy
  • Ambulatory blood pressure
  • Sleep quantity
  • Sleep quality
  • Cardiorespiratory fitness