D'agata, Michele N.Hoopes, Elissa K.Keiser. ThomasPatterson, FredaSzymanski, Krista M.Matias, Alexs A.Brewer, Benjamin C.Witman, Melissa A.2024-07-122024-07-122024-07-09D'agata MN, Hoopes EK, Keiser T, et al. Device-estimated sleep metrics do not mediate the relation between race and blood pressure dipping in young black and white women. J Clin Hypertens. 2024; 26: 850–860. https://doi.org/10.1111/jch.148561751-7176https://udspace.udel.edu/handle/19716/34572This article was originally published in Journal of Clinical Hypertension . The version of record is available at: https://doi.org/10.1111/jch.14856 © 2024 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Short, disturbed, and irregular sleep may contribute to blunted nocturnal blood pressure (BP) dipping, a predictor of cardiovascular disease. Black women (BLW) demonstrate less BP dipping and poorer sleep health than White women (WHW). However, it remains unclear whether device-estimated sleep health metrics mediate the relation between race and BP dipping in young women. We hypothesized that the relation between race and BP dipping would be partly mediated by sleep health metrics of sleep duration, sleep efficiency, and sleep regularity. Participants (20 BLW, 17 WHW) were 18–29 years old, normotensive, nonobese, and without evidence of sleep disorders. Systolic and diastolic BP dipping were derived from 24-h ambulatory BP monitoring. Habitual sleep duration and sleep efficiency were estimated via 14 days of wrist actigraphy. Sleep duration regularity was calculated as the standard deviation (SD) of nightly sleep duration (SDSD). Sleep timing regularity metrics were calculated as the SD of sleep onset and sleep midpoint (SMSD). Mediation analysis tested the mediating effect of each sleep metric on the relation between race and BP dipping. BLW experienced less systolic (P = .02) and diastolic (P = .01) BP dipping. Sleep duration (P = .14) was not different between groups. BLW had lower sleep efficiency (P < .01) and higher SDSD (P = .02), sleep onset SD (P < .01) and SMSD (P = .01). No sleep metrics mediated the relation between race and BP dipping (all indirect effects P > .38). In conclusion, mediation pathways of sleep health metrics do not explain racial differences in nocturnal BP dipping between young BLW and WHW.en-USAttribution-NonCommercial 4.0 InternationalArticle