How Does Sleep Apnea Affect Blood Pressure?

Hypertension, or high blood pressure, is a common health issue. It occurs when the force pumping blood through blood vessels is higher than normal. Many people who have high blood pressure don’t even know it. There aren’t always any symptoms to alert them that they have hypertension. It’s often discovered during a routine check at a doctor’s office.

Sleep apnea and high blood pressure may be more related than previously thought. In fact, the two conditions affect one another. Learning how to manage hypertension and treat sleep apnea can reduce the risk of harmful health effects.

OSA (Obstructive sleep apnea) is a sleep disorder, which causes breathing to stop and start while you are sleeping. Experts are still studying the effect of OSA on blood pressure, but they suggest several ways it may be related to a person’s increased risk of developing high blood pressure.¹ 

Individuals with sleep apnea have fragmented sleep patterns where breathing stops briefly, then normal breathing returns. When there is a partial or complete collapse of the upper airway, it can decrease the amount of oxygen in the blood. This changes the pressure in the chest and increases activity in the central nervous system.

These stressors trigger changes in the nervous system, immune system, and metabolism. There are different ways that these effects of obstructive sleep apnea may lead to elevated blood pressure.

Normal inflammation is what the immune system uses to protect the body. However, if inflammation lasts too long, it can damage the heart and blood vessels. OSA causes oxygen to drop repeatedly, and the central nervous system is activated. An overly active nervous system can result in persistent inflammation, which can cause high blood pressure.

For most people, blood pressure drops while they sleep. However, blood pressure may not decrease during sleep with people who have OSA. When the body misses out on natural drops in blood pressure, it can increase the risk of developing hypertension.

While sleeping, the heart rate gradually slows. This is the natural process of rest and recovery. Sleep apnea disrupts the natural heart rate changes that occur during sleep. This may explain why sleep apnea is linked to different cardiovascular problems.

The combination of sleep apnea and hypertension can significantly increase health risks, including:

• Cardiovascular Disease: Both OSA and hypertension are major risk factors for developing heart disease. They also increase the risk of having a stroke.

• Daytime Fatigue and Cognitive Impairment: Poor sleep quality can affect concentration, increase daytime sleepiness and fatigue, and negatively affect one’s overall cognitive function.

• Metabolic Syndrome: Hypertension causes stress on the arterial walls and can also affect the kidneys and the heart. If it is not managed properly, high blood pressure increases the risk of diabetes, stroke, and heart disease.

Recent studies have indicated that CPAP therapy can help lower blood pressure, especially in individuals with obstructive sleep apnea. According to the American Academy of Sleep Medicine, individuals who consistently used CPAP therapy saw a significant drop in blood pressure. ²

Using a CPAP machine can be effective for treating sleep apnea. The CPAP keeps the airway open with continuous pressure. This helps prevent repeated breathing interruptions during sleep. When the CPAP machine maintains an open airway, stable oxygen levels are the result, which helps reduce abnormal fluctuations in blood pressure.

Medical treatments like CPAP therapy can be very effective. Making some lifestyle changes along with regular CPAP therapy can improve your symptoms, help manage high blood pressure, and improve your sleep quality. Here are a few positive lifestyle changes that can help improve sleep apnea symptoms and improve your overall wellbeing.

Something as simple as changing sleep positions can make a big difference for people with sleep apnea. Lying on your back can make your symptoms worse since it causes the tongue and soft tissues to block your airway. Try these sleep position adjustments.

• Sleep on your side to help keep your airway open.
• Slightly elevate the head of your bed, which can help reduce airway obstruction.

If you are carrying excess weight, especially around the neck area, it can increase the pressure on your airway. This can increase your risk of airway collapse when you are sleeping. Losing weight can help reduce sleep apnea symptoms. Here are a few tips to help maintain a healthy weight.

• Include whole foods, fiber, and lean protein in your eating plan.
• Reduce the amount of processed foods, unhealthy fats, and sugar you consume.
• Exercise regularly and add activities like walking, swimming, or strength training to your routine.

Regular exercise can help reduce sleep apnea symptoms. It strengthens the heart and improves oxygen flow. Talk to your primary healthcare provider before starting a routine exercise program, especially if you haven’t been exercising. Here are some generally recommended tips for exercising:

• Work up to at least 150 minutes of moderate aerobic activity each week. Try brisk walking, cycling, or swimming.
•  Incorporate strength training into your workout routine at least twice a week. This helps build muscle mass and boosts your metabolism.
•  Enlist the help of a personal trainer who can help you find the exercise routine that is best for you.

Staying hydrated throughout the day can potentially help reduce symptoms and improve your overall sleep quality. Chronic dehydration has been associated with obstructive sleep apnea.³ Hydration can help decrease thirst and dry mouth, both commonly associated with sleep apnea. Being hydrated may also help relieve some symptoms like headaches, high blood pressure, and leg cramps. Here are a few tips for staying hydrated:

• Drink water throughout the day.
• Limit your alcohol and caffeine intake.
• Add hydrating foods to your eating plan.
• Avoid drinking too many fluids just before bed.

Smoking can increase fluid retention and inflammation in the airway, which makes sleep apnea symptoms worsen. Quitting smoking can help improve the quality of your sleep and your overall health. You do not have to do it alone. Here are some tips:

• Nicotine replacement therapy or prescribed medications.
• Joining support groups or getting counseling.
•  Lifestyle changes such as mindfulness or exercise can help reduce cravings.

Consuming alcohol can worsen sleep apnea symptoms for a few reasons. It tends to reduce the tone in the upper airway breathing muscles. Alcohol can also cause weight gain. It’s best to completely stop drinking alcohol if possible. Here are some tips to help manage alcohol consumption:

• Avoid consuming alcohol at least three hours before your bedtime.
• Limit alcohol use to the weekends.
• If you are a heavy drinker, reduce the amount you consume. Try to cut back to just one or two drinks per day, for starters.

Consuming nutritionally rich foods can help you manage blood pressure and improve your sleep apnea. A well-balanced diet can be instrumental in helping you lose weight as well. Here are a few tips on improving your diet.

• Eating less processed foods and not adding table salt to your food can drastically reduce your salt intake.
• Eat more whole grains, fruits, and vegetables.
• Choose low-fat dairy products.

Having a sleep routine can help your body regulate its internal clock and improve the quality of your rest. Here are a few tips for creating a healthy sleep routine:

• Go to bed and wake up at the same time every single day, including weekends.
• Create your own pre-bedtime routine. Give yourself time to wind down by reading or taking a warm bath.
• Create a sleep-friendly environment. Your bedroom should be dark, quiet, and cool.
• Reduce blue light exposure by avoiding screen time for at least an hour before bedtime.

If you have any concerns about sleep apnea, blood pressure, or poor sleep quality, it’s a good idea to talk with your primary doctor. If you have been diagnosed with either sleep apnea or high blood pressure, routine visits can help you manage your conditions and keep them both under control. They can provide medications or suggest lifestyle changes to help manage hypertension.

If you have not yet been diagnosed with sleep apnea, there are some symptoms of sleep apnea that indicate it’s time for a checkup. Let your doctor know if you experience any of these common sleep apnea symptoms.

• Sounds of gasping or choking when sleeping

• Frequent, very loud snoring

• Morning headaches

• Daytime drowsiness

• Waking up with a dry mouth or sore throat

CPAP therapy can effectively manage sleep apnea. For many people, managing sleep apnea also keeps hypertension in check. It is important to use the right CPAP equipment when treating obstructive sleep apnea. The CPAP Shop has a broad selection of CPAP machines, masks, and CPAP supplies designed to manage sleep apnea so you can get a good night’s sleep.

1. Somers, V. K., White, D. P., Amin, R., Abraham, W. T., Costa, F., Culebras, A., Daniels, S., Floras, J. S., Hunt, C. E., Olson, L. J., Pickering, T. G., Russell, R., Woo, M., & Young, T. (2008). Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. Hypertension, 52(5), 847–860. https://doi.org/10.1161/hypertensionaha.106.076190

2. American Academy of Sleep Medicine. (2014, May 21). CPAP rapidly improves blood pressure and arterial tone in adults with sleep apnea. https://aasm.org/cpap-rapidly-improves-blood-pressure-and-arterial-tone-in-adults-with-sleep-apnea/

3. Kenney, M. J., & Ganta, C. K. (2015). Chronic dehydration is associated with obstructive sleep apnea. Clinical Science, 128(3), 225–234. https://portlandpress.com/clinsci/article-abstract/128/3/225/70921/Chronic-dehydration-is-associated-with-obstructive