From the Guidelines
Decreased sleep can cause hypertension, and improving sleep hygiene is essential for hypertension prevention and management. Several clinical guidelines, including those from the American Heart Association, support the connection between decreased sleep and hypertension 1. The American Heart Association recognizes that poor sleep duration and quality are associated with CVD risk factors, including hypertension 1.
Key Findings
- Poor sleep duration and quality are associated with CVD risk factors, including hypertension 1.
- Chronic sleep deprivation can increase blood pressure and hypertension risk.
- Sleep deprivation activates the sympathetic nervous system, increasing stress hormones like cortisol and adrenaline, and causing inflammation—all of which elevate blood pressure.
- Improving sleep hygiene is recommended alongside traditional treatments for patients with hypertension.
Recommendations
- Maintain consistent sleep schedules.
- Create a dark and quiet bedroom environment.
- Avoid screens before bedtime.
- Limit caffeine and alcohol.
- Address sleep disorders like sleep apnea, which has a particularly strong association with resistant hypertension 1.
The physiological mechanism involves sleep deprivation disrupting normal blood pressure dipping patterns that occur during healthy sleep. For patients with hypertension, improving sleep hygiene is crucial, and healthcare professionals can screen for poor sleep, remove sleep-reducing medications, address sleep-reducing behaviors, and judiciously prescribe sleep-enhancing medications 1.
From the Research
Guidelines Supporting the Claim
The claim that decreased sleep can cause hypertension is supported by several studies, including:
- A 2022 review published in the American Journal of Hypertension, which highlights the relationship between sleep duration and blood pressure regulation 2.
- A 2018 study published in Current Hypertension Reports, which found that insomnia and short sleep duration are associated with elevated blood pressure and hypertension 3.
- A 2018 study published in Sleep, which found that changes in sleep duration, including decreases in sleep duration, are associated with an increased risk of hypertension in healthy adults 4.
- A 2013 systematic review and meta-analysis published in Sleep Medicine, which found that short sleep duration is associated with a greater risk of hypertension, and that a U-shaped relationship exists between habitual sleep duration and hypertension 5.
- A 2021 review published in Hypertension, which summarizes the recent literature on the association between sleep disturbances, including short sleep duration, and hypertension risk 6.
Key Findings
Key findings from these studies include:
- Decreased sleep duration is associated with an increased risk of hypertension 4, 5.
- Insomnia and short sleep duration are associated with elevated blood pressure and hypertension 3.
- A U-shaped relationship exists between habitual sleep duration and hypertension, with both short and long sleep durations associated with an increased risk of hypertension 5.
- Sleep disturbances, including short sleep duration and obstructive sleep apnea, are associated with higher blood pressure levels and an increased risk of hypertension 6.
Implications
These findings have implications for the prevention and management of hypertension, including:
- The importance of maintaining moderate sleep duration to prevent hypertension 4, 5.
- The need to identify and treat sleep disturbances, including insomnia and obstructive sleep apnea, in patients with hypertension 3, 6.
- The potential for sleep health interventions to lower blood pressure and improve blood pressure control in patients with hypertension 6.