One-third of non-institutionalized adults in the United States have hypertension, or high blood pressure. Among hospitalized patients and residents of nursing homes and other long-term care settings, the prevalence of hypertension is even higher. In the past two decades the incidence of hypertension has increased among Americans. At the same time, the average duration of sleep in the U.S. has declined, leading some scientists to believe that sleep disorders are at the root of many cases of hypertension.
Sleep Deprivation
Short sleep duration is a significant risk factor for hypertension. Following a review of data generated by nearly 5,000 subjects from the first National Health and Nutrition Examination Survey, investigators at Columbia University determined that sleep durations of 5 hours or less per night were associated with the development of hypertension in individuals between the ages of 32 and 59 years. Even when other health problems, such as obesity and diabetes, were not present, shortened sleep was strongly correlated with elevated blood pressure.
Obstructive Sleep Apnea
Obstructive sleep apnea, or OSA, is a condition caused by blockage of your airway during sleep. OSA is more common in overweight people, but it can occur whenever relaxation of your upper airway is significant enough to interfere with your ability to breathe normally. In 2000, a study performed at Canada’s University of Toronto involving more than 2,600 patients demonstrated a compelling link between OSA and hypertension. Furthermore, the hypertension in OSA is resistant to treatment until the sleeping disorder is addressed. When OSA is successfully treated with continuous positive airway pressure, or CPAP, hypertension responds more readily to medical treatment.
Central Sleep Apnea
Although obstructive sleep apnea is most strongly linked to hypertension, other sleep-related breathing disorders are also associated with an increased incidence of high blood pressure and heart disease. Central sleep apnea, a condition characterized by abnormalities in your brain’s respiratory driving mechanism, increases your risk for heart failure and, in people who already have heart failure, the risk for death. Unlike obstructive sleep apnea, central sleep apnea does not respond well to CPAP therapy.
Pregnancy
Sleep patterns are often disrupted during pregnancy, and both insomnia and excessive sleep are common among pregnant women. A study published in the October 2010 issue of “Sleep” demonstrated that women who slept less than five hours per night during early pregnancy had a higher risk for developing pregnancy-induced hypertension later on, mirroring the results of sleep-deprivation studies performed in non-pregnant populations. However, pregnant women who slept 10 hours or more were also more likely to develop pregnancy-induced hypertension.
Considerations
Hypertension is more common among people whose sleep is disrupted, and hypertension in a person with a sleep disorder is often resistant to medical treatment. In fact, if your high blood pressure is not responding to the medications prescribed by your physician, ask about getting evaluated for a sleep disorder. If you have already been diagnosed with a sleep disorder, such as obstructive sleep apnea, adhering to your treatment plan could reduce your blood pressure and decrease your chances of experiencing heart attack, stroke or congestive heart failure.
References
- Centers for Disease Control and Prevention: FastStats – Hypertension
- “Hypertension”; Short Sleep Duration as a Risk Factor for Hypertension: Analyses of the First National Health and Nutrition Examination Survey; James E. Gangwisch, et al; May 2006
- “British Medical Journal”; Obstructive Sleep Apnea Syndrome as a Risk Factor for Hypertension: A Population Study; Peretz Lavie, et al.; February 2000
- “Respiratory Care”; Sleep Disordered Breathing and Cardiovascular Disorders; Rohit Budhiraja, et al.; November 2010
- “Sleep”; Associations of Early Pregnancy Sleep Duration With Trimester-Specific Blood Pressures and Hypertensive Disorders in Pregnancy; Michelle A. Williams, et al.; October 2010
