Nocturnal Hypertension: The Hidden Sleep Danger That Raises Heart and Kidney Disease Risk
Plus, learn how to bring your BP down while sleeping
When it’s finally time to turn in for the night, you assume your body, including your heart and blood vessels, is entirely at rest. But for some people, nighttime brings unexpected shifts that can quietly affect long-term heart health. Why? Typically, your blood pressure takes a dip during snoozing hours. This natural drop gives your cardiovascular system a much-needed break. But when that dip doesn’t happen, it can lead to what’s known as nocturnal hypertension.
That’s a problem since elevated blood pressure overnight not only affects sleep quality but can also put you at a higher risk of serious conditions such as heart disease. Keep reading to hear from experts about this condition, why it often goes unnoticed, and how to prevent bedtime blood pressure spikes.
What is nocturnal hypertension?
If you have high blood pressure (also known as hypertension), you may also experience the sleep disorder nocturnal hypertension—a condition where your blood pressure remains elevated or even rises at night instead of following the normal dip that occurs during sleep. In most people, our average nighttime systolic (top number) and diastolic (bottom number) blood pressure is approximately 15 percent lower than our daytime value, explains Raj Dasgupta, MD, chief medical advisor for Sleepopolis.
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He says it’s known as “nondipping” when your levels fail to fall by at least 10 percent during sleep, and it’s a risk factor for heart failure and other cardiovascular health complications. “In general, nocturnal hypertension is a concern because it puts extra strain on your heart and can be an early warning sign of cardiovascular disease, stroke or kidney issues.” (Discover more subtle early symptoms of heart disease here.)
Symptoms of nocturnal hypertension
Similar to regular hypertension, nocturnal hypertension isn’t always easy to spot because it lacks obvious symptoms. With that in mind, Raven Voora, MD, hypertension specialist and nephrologist at UNC Health, notes that it’s associated with poor sleep, sleep apnea, breathlessness during sleep or frequently waking with the need to urinate at night. (Here’s how to tell if you have sleep apnea.)
If you have to take your blood pressure overnight, Dr. Voora says the best time to do it is at 2, 3 and 4 a.m. because they provide the most reliable data on blood pressure patterns during sleep. However, waking up to take blood pressure readings is not ideal, as disrupting your natural sleep patterns causes your blood pressure to fluctuate.
Instead, try obtaining readings right before bed for a baseline and check them as soon as you wake up. Some smartwatches and other newer wearable fitness can help estimate your blood pressure readings overnight. While they’re not as accurate as using a blood pressure cuff to take your reading, they can help clue you into any BP issues you might be experiencing while you’re asleep.
How nocturnal hypertension is diagnosed
The standard for determining whether or not you have nocturnal hypertension is obtaining an ambulatory blood pressure monitoring (ABPM) device from your doctor. “This device tests and monitors your blood pressure in intervals, providing a map of your blood pressure patterns as you sleep,” says Dr. Voora. If an ABPM is not an option, you could use a home blood pressure monitoring device, which can be found over the counter.
How to prevent nighttime blood pressure spikes
Dealing with high blood pressure can seem daunting, but luckily, there are easy ways to reduce spikes at bedtime. These include:
- Cutting back on salt and alcohol
- Avoiding caffeine late at night
- Maintaining a consistent sleep routine
- Reducing stress as much as possible
- Eating a healthy diet and exercising regularly
When to talk to your doctor about nocturnal hypertension
It’s smart to check in with your doctor if your blood pressure levels aren’t improving even after medication or treatment. “Symptoms that may suggest nocturnal hypertension—such as morning headaches, waking up tired, frequent nighttime awakenings or restless sleep—are all signs that you should see a doctor,” says Dr. Voora.
Dr. Dasgupta adds that if you have other conditions like obstructive sleep apnea or kidney problems, then you should talk with a healthcare professional sooner rather than later to help reduce your risk of more serious heart health complications.
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