The Relationship Between Weekend Catch-Up Sleep and Hypertension: Insights From the National Health and Nutrition Examination Survey, 2017-2023.

OBJECTIVE: Sleep deprivation is associated with an increased risk of hypertension (HTN), and many individuals practice weekend catch-up sleep (WCS). However, evidence of an association between WCS and HTN in adults in the United States remains limited. This study examines this relationship using a nationally representative sample. METHODS: Data from NHANES 2017-2023 (16,268 adults aged ≥ 20 years) were analyzed. The WCS was defined as weekend sleep minus weekday sleep. Multivariate logistic regression was used to adjust for sociodemographic, lifestyle, and metabolic factors. WCS was examined as a binary (> 0 vs. ≤ 0 h), continuous, and categorical (≤ 0, 0-1, 1-2, 2-3, and ≥ 3 h) variable. Subgroup analyses were exploratory and not corrected for multiple testing. RESULTS: In the fully adjusted models, neither the binary nor continuous WCS duration was significantly associated with HTN (p > 0.05). Among categorical analyses, only the 0-1 h WCS group showed lower odds of HTN compared with the ≤ 0 h group (OR = 0.814, 95% CI: 0.666-0.995, p = 0.033); all other WCS categories (1-2 h, 2-3 h, and ≥ 3 h) were nonsignificant. No dose-response relationship was observed. Subgroup analyses suggested potential effect modification by sex and education, but these results are hypothesis-generating given the lack of correction for multiple comparisons. CONCLUSION: In this large cross-sectional study, the WCS was not robustly associated with HTN. The isolated finding of 0-1 h of WCS requires confirmation in prospective studies and should not be interpreted as evidence for a preventive or therapeutic strategy.