This Habit Raises Your Risk of High Blood Pressure

Nearly 50% of Americans have high blood pressure, but only a quarter have it under control. Known as the “silent killer,” high blood pressure often shows no symptoms but increases the risk of heart disease, heart failure, stroke and other chronic illnesses.

If you want to improve your numbers but diet and exercise aren’t enough, your sleep habits may need some attention. “Sleep helps control blood pressure by balancing hormones, nerves, and the way blood vessels work. If you don’t sleep well, your blood pressure can stay high at night and during the day,” explains David CM Corteville, MD, FACC, CPE.

In 2022, the American Heart Association updated its cardiovascular health checklist – called Vital 8– to include sleep, highlighting how important sleep is for heart health. Read on to find out how better sleep can reduce your risk of high blood pressure and help manage diagnosed hypertension, and learn cardiologist-recommended strategies for getting a good night’s sleep.

How sleep affects blood pressure

Sleep duration – the number of hours you sleep – is often the focus, but it is only part of the equation. “Various sleep variables, such as how long you sleep, how well you sleep, and how regular your sleep schedule is, can all affect your risk of high blood pressure, and each is important in its own way,” he says David Rizik, MD. Here’s a closer look at how each of these three sleep factors can affect your risk.

Sleep duration

Both too little and too much sleep can increase the risk of high blood pressure, says Rizik. The sweet spot? About seven to nine hours per night for adults. “Regular intake for less than seven hours or more than nine hours is associated with a higher risk of developing high blood pressure over time.”

For example, a meta-analysis of 16 studies with over 1 million participants found that sleeping less than seven hours per night increased the risk of high blood pressure by 7%, while sleeping less than five hours increased the risk to 11%. The connection between long sleep and high blood pressure is less clear – some studies show an increased risk, while others find no connection. Therefore, further research is needed.

Sleep quality

Spending seven to nine hours in bed does not automatically mean it was restful. “Poor sleep quality—such as frequent tossing and turning or waking up—is strongly linked to higher blood pressure and a higher risk of developing high blood pressure, even if you’re technically in bed long enough,” explains Rizik.

In a study of 33,000 adults, those who rated their sleep quality as “fairly poor” had a 22% higher risk of high blood pressure, while participants with “very poor” sleep quality had a 48% higher risk than those who reported good sleep quality.

Regularity of sleep

When you sleep can be just as important as how much you sleep. “People whose sleep patterns vary widely are much more likely to develop high blood pressure than people with a more regular sleep pattern,” says Rizik.

The effects of irregular sleep can appear surprisingly quickly. A study of 1,600 older adults found that just one week of irregular sleep led to increased blood pressure – even in adults without high blood pressure. In the long term, the impact is even greater. A nine-month study of more than 12,000 adults showed that an average bedtime variation of 34 minutes increased the risk of high blood pressure by up to 32%. In fact, the researchers found that sleep irregularities increased the risk of high blood pressure regardless of total sleep duration or the time they went to bed, suggesting that consistency itself is a key factor.

Your body’s circadian rhythm — an internal 24-hour clock — helps regulate blood pressure. Irregular sleep disruption can throw your nervous system out of balance and put your cardiovascular system under chronic stress.

Sleep apnea and blood pressure risk

If you have obstructive sleep apnea, there’s a good chance you also have high blood pressure – up to 50% of people with OSA also have high blood pressure and vice versa.

“Sleep apnea is a common condition in which breathing stops and starts several times during sleep,” says Corteville. He explains that this drop in oxygen puts strain on the heart and blood vessels and increases the risk of high blood pressure, especially at night.

OSA is particularly common in people with resistant hypertension – blood pressure that remains high even with medication or other therapies. Corteville recommends discussing screening, testing, and treatment with your doctor if you have high blood pressure or suspect you have OSA. Treatment options such as CPAP machines or implantable devices can help keep your airways open, improve oxygen levels, and reduce strain on your heart and blood vessels to support healthy blood pressure.

How to sleep better

Improving your sleep doesn’t have to mean a complete overhaul of your life. Small, consistent changes can make a big difference in your overall sleep quality and blood pressure management. This is what the experts recommend:

• Stick to a consistent bedtime. “Go to bed and get up at the same time every day, even on weekends,” advises Rizik. “This helps keep your body’s clock regular, which is linked to healthier blood pressure.”
• Customize your environment. For the best sleep, make sure your bedroom is dark, quiet, and cool. If necessary, Rizik suggests trying blackout curtains or a white noise machine to block out distracting light and noise.
• Limit screens before bed. “The blue light from phones, tablets, and TVs can interfere with your body’s signal to become sleepy,” explains Rizik. Turn off the screen at least 30 to 60 minutes before bed to allow your body to naturally prepare for sleep.
• Create a calming bedtime routine. “Establish a relaxing routine, such as reading, gentle stretching exercises, or calm music,” suggests Rizik. “Stress can keep you awake, so anything that helps you relax can promote your sleep.” Deep breathing exercises can also help calm your nervous system.
• Choose late night snacks wisely. “Avoid large meals, caffeine and alcohol close to bedtime,” warns Rizik. “All of these can affect sleep quality.”
• Avoid smoking. While avoiding smoking altogether is crucial for heart health, Corteville points out that smoking before bed can disrupt sleep, as nicotine can make it difficult to fall and stay asleep.
• Spend time outside during the day. “Daytime sunlight helps regulate your body’s internal clock, making it easier for you to fall asleep at night,” notes Rizik. Try to spend time outdoors, especially in the morning. Light therapy boxes can also be helpful on cloudy days or in the winter months.

Our expert opinion

Sleep is an effective way to reduce the risk of high blood pressure and manage existing high blood pressure. Getting consistent, high-quality sleep gives your cardiovascular system the time it needs to rest and recover each night. To improve your sleep, start with small changes: create a relaxing sleep environment, limit screens before bed, limit your exposure to daylight, and cut down on caffeine and alcohol. If you suspect that an underlying condition such as sleep apnea is affecting your sleep, talk to your doctor about testing and treatment options.