Table of ContentsView AllTable of ContentsConnectionIf UntreatedTreatment and ManagementPrevention
Table of ContentsView All
View All
Table of Contents
Connection
If Untreated
Treatment and Management
Prevention
Sleep apnea, or specifically obstructive sleep apnea (OSA), is linked to hypertension (high blood pressure). OSA affects 30% to 40% of people with hypertension, and up to half of those who have OSA have high blood pressure.Even so, hypertension tends to be secondary to OSA, and OSA can lead to or exacerbate hypertension.
In healthy people,blood pressure dippingoccurs when there is a 10% to 20% drop in blood pressure when you sleep.People with OSA will experience non-dipping blood pressure, which can mean an increased risk of cardiovascular disease (conditions that affect the heart and blood vessels).
Both OSA and hypertension are treatable, and high blood pressure can be reversed with medication and lifestyle changes. In addition, continuous positive airway pressure (CPAP) machines used to treat sleep apnea can help lower blood pressure and reduce your risk for cardiovascular events like heart attack and stroke.
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Connection Between Sleep Apnea and Hypertension
Obstructive sleep apneais a disorder in which the airway becomes blocked while you are sleeping.This causes you to wake up frequently throughout the night.
Symptoms of OSA may include:
Hypertensionhappens when the force of blood pumping against the walls of the arteries is consistently high.High blood pressure forces the heart and blood vessels to work harder than they should.
Most people with high blood pressure do not have symptoms. If you have symptoms, you may experience headaches,shortness of breath, and nosebleeds.
Persistent high blood pressure, nighttime hypertension, abnormal blood pressure increases, and vascular remodeling are characteristics of OSA-related hypertension.Vascular remodeling is an abnormal thickening and loss of elasticity of the vascular wall.
People with OSA have a higher than average risk of developing high blood pressure.Further, people with high blood pressure have a higher risk of OSA compared to their peers.
The ways in which sleep apnea increases blood pressure are:
Other OSA-Hypertension Factors
OSA has additional effects related to hypertension. These, which are often connected, can affect the cardiocirculatory system and include:
These effects increase during sleep and can remain high during wakefulness.
What Is the Sympathetic Nervous System?
Daytime Hypertension
Blood pressure changes linked to OSA do not necessarily stop when you wake up. People with OSA will also experience suddenly elevated blood pressure first thing in the morning.
This morning surge may be another risk factor for cardiovascular disease. If OSA is severe,daytime blood pressurelevels may increase.
What Is Nocturnal Hypertension?
Daytime blood pressure changes are a crucial reason touse a CPAP machine. You can also manage your blood pressure with medication and lifestyle changes, such as eating a healthy and balanced diet, exercising, and managing stress.
Shared Risk FactorsOSA and high blood pressure develop as a result of risk factors, many of which are shared.Shared risk factors include:Abnormalvasoconstriction(the narrowing of blood vessels due to contractions of the muscular wall)Advancing ageAtherosclerosisHaving obesityMale sexVascular injuries
Shared Risk Factors
OSA and high blood pressure develop as a result of risk factors, many of which are shared.Shared risk factors include:Abnormalvasoconstriction(the narrowing of blood vessels due to contractions of the muscular wall)Advancing ageAtherosclerosisHaving obesityMale sexVascular injuries
OSA and high blood pressure develop as a result of risk factors, many of which are shared.
Shared risk factors include:
Risks of Not Treating Either
OSA and hypertension can be dangerous conditions, and they require treatment. For example, untreated sleep apnea is linked to high blood pressure, heart disease, diabetes, and depression.Untreated hypertension can damage the heart, arteries, kidneys, brain, and eyes.
Untreated sleep apnea can increase your risk for cardiovascular disease and can lead to worse health outcomes fromcardiovascular disease.OSA, specifically, has been linked to high blood pressure, stroke, andcoronary artery disease. Untreated sleep apnea may also increase the risk ofheart failure.
OSA can lead to resistant hypertension if left untreated.Resistant hypertension is uncontrolled blood pressure that is consistently over 130/80 millimeters of mercury (mmHg) and requires three or moreantihypertensive drugs.Resistant hypertension increases your risk for the following:
Upper respiratory reduction (airflow limitation) is often seen in resistant hypertension.OSA affects 83% of people with resistant hypertension.
People with hypertension are also more susceptible to nighttime fluid retention, which worsens their OSA and leads to blood pressure surges that eventually cause resistant hypertension.
The Health Effects of Sleep Apnea
CPAP therapy is vital for OSA and may help lower blood pressure. However, CPAP therapy alone is not enough to treat high blood pressure.
Many medications are available to manage blood pressure. They fall into different classes of drugs that lower blood pressure in different ways.
These drug classes are:
Lifestyle changes are also very effective for managing blood pressure. These can include:
12 Tricks to Lower Your Blood Pressure Instantly at Home
For some people, surgery may be needed to unblock obstructions related to sleep apnea.
Surgical options may include:
Asleep specialistor other healthcare provider can explain surgical options for managing sleep apnea and advise you on whether surgery is a safe and reasonable option for you.
Misdiagnoses
Sleep apnea can sometimes be missed in people with resistant hypertension.Occult hypertensionmight also be misdiagnosed in people with OSA.
With resistant hypertension, numbers may be extraordinarily high, and the focus may be on the hypertension and not any sleep issues. With occult hypertension, there are no symptoms of increased blood pressure.
What Is Occult Hypertension?Occult high blood pressure is also known asasymptomatic hypertension.It is high blood pressure without noticeable symptoms.
What Is Occult Hypertension?
Occult high blood pressure is also known asasymptomatic hypertension.It is high blood pressure without noticeable symptoms.
In some cases of secondary hypertension, higher blood pressure may only exist during sleep or fail to lower during sleep. Because of lower daytime measurements, a missed hypertension diagnosis can result.
One study of 130 people with OSA found that 30% had masked hypertension.With these study participants, episodes of apnea and nighttime hypertension coexisted, but daytime numbers were regular.
How to Manage Progressive Pulmonary Hypertension
It is possible to prevent OSA and hypertension or prevent the development of one of these conditions as a secondary condition of another.
You can prevent these conditions in the following ways:
Summary
The relationship between sleep apnea and hypertension is well-established. Sleep apnea can contribute to the development and worsening of hypertension, and OSA can occur as a result of uncontrolled hypertension.
Repeated breathing interruptions while you sleep can lead to intermittent oxygen drops and increased carbon dioxide in the blood. These oxygen drops can elevate your heart rate and blood pressure while you sleep and during the day. Over time, you may experience resistant hypertension that may worsen the severity of apneic episodes.
People with OSA and hypertension have an increased risk for cardiovascular diseases, so it is crucial to manage and treat both conditions. CPAP therapy can help manage sleep apnea and can allow for improvements in blood pressure.
Hypertension should also be treated with medication. Lifestyle therapies, such as addressing sleep hygiene, staying active, not smoking, managing stress, and eating a healthy diet, can also prevent sleep apnea and hypertension or reduce their severity.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Surani SR.Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?World J Diabetes. 2014;5(3):381-384. doi:10.4239/wjd.v5.i3.381Brown J, Yazdi F, Jodari-Karimi M, Owen JG, Reisin E.Obstructive sleep apnea and hypertension: updates to a critical relationship.Curr Hypertens Rep. 2022;24(6):173-184. doi:10.1007/s11906-022-01181-wBloomfield D, Park A.Night time blood pressure dip.World J Cardiol. 2015;7(7):373-376. doi:10.4330/wjc.v7.i7.373Penn Medicine.Obstructive sleep apnea - symptoms and causes.American Heart Association.What is high blood pressure?Shiina K.Obstructive sleep apnea -related hypertension: a review of the literature and clinical management strategy. Hypertens Res. 2024;47(11):3085-3098. doi:10.1038/s41440-024-01852-yZeng X, Yang Y.Molecular mechanisms underlying vascular remodeling in hypertension.Rev Cardiovasc Med. 2024;25(2):72. doi:10.31083/j.rcm2502072Marrone O, Bonsignore MR.Blood-pressure variability in patients with obstructive sleep apnea: current perspectives.Nat Sci Sleep. 2018;10:229-242. doi:10.2147/NSS.S148543Patel AR, Patel AR, Singh S, Singh S, Khawaja I.The association of obstructive sleep apnea and hypertension.Cureus. 2019;11(6):e4858. doi:10.7759/cureus.4858American Heart Association.Sleep apnea and heart health.Chia R, Pandey A, Vongpatanasin W.Resistant hypertension-defining the scope of the problem.Prog Cardiovasc Dis. 2020;63(1):46-50. doi:10.1016/j.pcad.2019.12.006American Heart Association.Types of blood pressure medications.Sleep Foundation.Surgical treatments for sleep apnea.Castriotta RJ.Sense and sensitivity: obstructive sleep apnea, morning blood pressure, and occult hypertension.J Clin Sleep Med. 2017;13(7):861-862. doi:10.5664/jcsm.6652Dowd CM, Gallagher B, Kessler CS, Svingos R.Asymptomatic hypertensive urgency at a VA emergency department.Fed Pract. 2018;35(3):33-39.Marquina C, Makarounas-Kirchmann K, Holden K, Sasse A, Ademi Z.The preventable productivity burden of sleep apnea in Australia: a lifetime modeling study.J Sleep Res. 2023;32(2):e13748. doi:10.1111/jsr.13748MedlinePlus.How to prevent high blood pressure.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Surani SR.Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?World J Diabetes. 2014;5(3):381-384. doi:10.4239/wjd.v5.i3.381Brown J, Yazdi F, Jodari-Karimi M, Owen JG, Reisin E.Obstructive sleep apnea and hypertension: updates to a critical relationship.Curr Hypertens Rep. 2022;24(6):173-184. doi:10.1007/s11906-022-01181-wBloomfield D, Park A.Night time blood pressure dip.World J Cardiol. 2015;7(7):373-376. doi:10.4330/wjc.v7.i7.373Penn Medicine.Obstructive sleep apnea - symptoms and causes.American Heart Association.What is high blood pressure?Shiina K.Obstructive sleep apnea -related hypertension: a review of the literature and clinical management strategy. Hypertens Res. 2024;47(11):3085-3098. doi:10.1038/s41440-024-01852-yZeng X, Yang Y.Molecular mechanisms underlying vascular remodeling in hypertension.Rev Cardiovasc Med. 2024;25(2):72. doi:10.31083/j.rcm2502072Marrone O, Bonsignore MR.Blood-pressure variability in patients with obstructive sleep apnea: current perspectives.Nat Sci Sleep. 2018;10:229-242. doi:10.2147/NSS.S148543Patel AR, Patel AR, Singh S, Singh S, Khawaja I.The association of obstructive sleep apnea and hypertension.Cureus. 2019;11(6):e4858. doi:10.7759/cureus.4858American Heart Association.Sleep apnea and heart health.Chia R, Pandey A, Vongpatanasin W.Resistant hypertension-defining the scope of the problem.Prog Cardiovasc Dis. 2020;63(1):46-50. doi:10.1016/j.pcad.2019.12.006American Heart Association.Types of blood pressure medications.Sleep Foundation.Surgical treatments for sleep apnea.Castriotta RJ.Sense and sensitivity: obstructive sleep apnea, morning blood pressure, and occult hypertension.J Clin Sleep Med. 2017;13(7):861-862. doi:10.5664/jcsm.6652Dowd CM, Gallagher B, Kessler CS, Svingos R.Asymptomatic hypertensive urgency at a VA emergency department.Fed Pract. 2018;35(3):33-39.Marquina C, Makarounas-Kirchmann K, Holden K, Sasse A, Ademi Z.The preventable productivity burden of sleep apnea in Australia: a lifetime modeling study.J Sleep Res. 2023;32(2):e13748. doi:10.1111/jsr.13748MedlinePlus.How to prevent high blood pressure.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Surani SR.Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?World J Diabetes. 2014;5(3):381-384. doi:10.4239/wjd.v5.i3.381Brown J, Yazdi F, Jodari-Karimi M, Owen JG, Reisin E.Obstructive sleep apnea and hypertension: updates to a critical relationship.Curr Hypertens Rep. 2022;24(6):173-184. doi:10.1007/s11906-022-01181-wBloomfield D, Park A.Night time blood pressure dip.World J Cardiol. 2015;7(7):373-376. doi:10.4330/wjc.v7.i7.373Penn Medicine.Obstructive sleep apnea - symptoms and causes.American Heart Association.What is high blood pressure?Shiina K.Obstructive sleep apnea -related hypertension: a review of the literature and clinical management strategy. Hypertens Res. 2024;47(11):3085-3098. doi:10.1038/s41440-024-01852-yZeng X, Yang Y.Molecular mechanisms underlying vascular remodeling in hypertension.Rev Cardiovasc Med. 2024;25(2):72. doi:10.31083/j.rcm2502072Marrone O, Bonsignore MR.Blood-pressure variability in patients with obstructive sleep apnea: current perspectives.Nat Sci Sleep. 2018;10:229-242. doi:10.2147/NSS.S148543Patel AR, Patel AR, Singh S, Singh S, Khawaja I.The association of obstructive sleep apnea and hypertension.Cureus. 2019;11(6):e4858. doi:10.7759/cureus.4858American Heart Association.Sleep apnea and heart health.Chia R, Pandey A, Vongpatanasin W.Resistant hypertension-defining the scope of the problem.Prog Cardiovasc Dis. 2020;63(1):46-50. doi:10.1016/j.pcad.2019.12.006American Heart Association.Types of blood pressure medications.Sleep Foundation.Surgical treatments for sleep apnea.Castriotta RJ.Sense and sensitivity: obstructive sleep apnea, morning blood pressure, and occult hypertension.J Clin Sleep Med. 2017;13(7):861-862. doi:10.5664/jcsm.6652Dowd CM, Gallagher B, Kessler CS, Svingos R.Asymptomatic hypertensive urgency at a VA emergency department.Fed Pract. 2018;35(3):33-39.Marquina C, Makarounas-Kirchmann K, Holden K, Sasse A, Ademi Z.The preventable productivity burden of sleep apnea in Australia: a lifetime modeling study.J Sleep Res. 2023;32(2):e13748. doi:10.1111/jsr.13748MedlinePlus.How to prevent high blood pressure.
Surani SR.Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?World J Diabetes. 2014;5(3):381-384. doi:10.4239/wjd.v5.i3.381
Brown J, Yazdi F, Jodari-Karimi M, Owen JG, Reisin E.Obstructive sleep apnea and hypertension: updates to a critical relationship.Curr Hypertens Rep. 2022;24(6):173-184. doi:10.1007/s11906-022-01181-w
Bloomfield D, Park A.Night time blood pressure dip.World J Cardiol. 2015;7(7):373-376. doi:10.4330/wjc.v7.i7.373
Penn Medicine.Obstructive sleep apnea - symptoms and causes.
American Heart Association.What is high blood pressure?
Shiina K.Obstructive sleep apnea -related hypertension: a review of the literature and clinical management strategy. Hypertens Res. 2024;47(11):3085-3098. doi:10.1038/s41440-024-01852-y
Zeng X, Yang Y.Molecular mechanisms underlying vascular remodeling in hypertension.Rev Cardiovasc Med. 2024;25(2):72. doi:10.31083/j.rcm2502072
Marrone O, Bonsignore MR.Blood-pressure variability in patients with obstructive sleep apnea: current perspectives.Nat Sci Sleep. 2018;10:229-242. doi:10.2147/NSS.S148543
Patel AR, Patel AR, Singh S, Singh S, Khawaja I.The association of obstructive sleep apnea and hypertension.Cureus. 2019;11(6):e4858. doi:10.7759/cureus.4858
American Heart Association.Sleep apnea and heart health.
Chia R, Pandey A, Vongpatanasin W.Resistant hypertension-defining the scope of the problem.Prog Cardiovasc Dis. 2020;63(1):46-50. doi:10.1016/j.pcad.2019.12.006
American Heart Association.Types of blood pressure medications.
Sleep Foundation.Surgical treatments for sleep apnea.
Castriotta RJ.Sense and sensitivity: obstructive sleep apnea, morning blood pressure, and occult hypertension.J Clin Sleep Med. 2017;13(7):861-862. doi:10.5664/jcsm.6652
Dowd CM, Gallagher B, Kessler CS, Svingos R.Asymptomatic hypertensive urgency at a VA emergency department.Fed Pract. 2018;35(3):33-39.
Marquina C, Makarounas-Kirchmann K, Holden K, Sasse A, Ademi Z.The preventable productivity burden of sleep apnea in Australia: a lifetime modeling study.J Sleep Res. 2023;32(2):e13748. doi:10.1111/jsr.13748
MedlinePlus.How to prevent high blood pressure.
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