Sleep Quality and Mechanisms of Cardiovascular Risks in Adults With Hypertension

Prior treatment

• Antihypertensive medication use
• Cardiovascular medications
• Previously diagnosed moderate or severe obstructive sleep apnea
• Alcohol or drug abuse within 12 months

Other illness

• Uncontrolled hypertension (screening office BP \> 160/100 mm Hg)
• Acute coronary syndrome or coronary revascularization procedure within 6 months of enrollment
• Congestive heart failure
• Identifiable cause of hypertension (e.g., primary hyperaldosteronism, renal artery stenosis, untreated hyper- or hypothyroidism, chronic kidney disease, Cushing's disease, pheochromocytoma, coarctation of the aorta)
• Severe uncorrected valvular heart disease
• Active diagnosis of psychosis, bipolar disorder
• Diabetes
• Psychiatric Hospitalization within the past 12 months
• Dementia
• Unstable comorbid sleep disorder requiring assessment and/or treatment outside of the study protocol
• Medical or psychiatric conditions judged to be the primary cause of insomnia

Other

• Severe obesity defined by BMI\>40 kg/m2
• Pacemakers
• Atrial fibrillation
• Current pregnancy
• Severely impaired hearing or speech
• Participation in another interventional study to address insomnia
• Rotating shift workers
• Prominent suicidal or homicidal ideation (as assessed through a clinical interview)
• Exposure-based PTSD treatment
• Inability to comply with the assessment procedures or inability to provide informed consent.

• Systolic BP ≥ 130 mm Hg based upon two standardized BP screening assessments
• A current diagnosis of insomnia disorder as defined in the International Classification of Sleep Disorders (ICSD-3); or undiagnosed, but suspected, insomnia disorder that is confirmed at their screening lab visit