Lauren is a board-certified adult-gerontology primary care nurse practitioner. Before furthering her education and becoming an NP she worked as a registered nurse in inpatient oncology/bone marrow transplant at Brigham and Women’s Hospital in Boston and most recently as a post-anesthesia care unit registered nurse in an outpatient surgery center. Prior to becoming a registered nurse, she worked in diabetes research at Joslin Diabetes Center in Boston. Lauren has done NP clinical practicums focusing on the adolescent, adult, and geriatric populations in internal medicine, long-term care, and in outpatient oncology/bone marrow transplant. Lauren received a BA from Assumption University, a BSN from Massachusetts College of Pharmacy and Health Sciences, and her MS in Nursing from the University of Massachusetts at Lowell. She is certified by the American Academy of Nurse Practitioners (AANP).

High blood pressure is more common than you may think. Almost half of all Americans in the United States suffer from hypertension. It’s especially concerning when only about one in four adults with the condition has it under control. Hypertension is known as the “silent killer” because it doesn’t show obvious symptoms and many people can go years without knowing they have it.  

When you have hypertension, you are at greater risk for heart disease and stroke – both of which are the leading causes of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). Almost half a million Americans lost their lives from hypertension in 2018 alone, with men at a greater risk than women. Part of what makes high blood pressure so dangerous is that it usually carries no symptoms, forcing you to be proactive about your health so you can detect when there is a problem. You can use a special meter to monitor your blood pressure and know whether your body is maintaining healthy levels or not.

The quality and quantity of your sleep also impact your blood pressure. A study by doctors David A. Calhoun and Susan M. Harding found that “both sleep deprivation and insomnia have been linked to increases in incidence and prevalence of hypertension. Likewise, sleep disruption attributable to restless legs syndrome increases the likelihood of having hypertension.” The research also pointed to a link between the severity of obstructive sleep apnea (OSA) and hypertension.

In this time of heightened health protocols, this is what every American needs to know about the correlation between high blood pressure, stress, and sleep.

What You Need to Know About High Blood Pressure and Sleep

Your arteries are responsible for carrying blood from your heart to other areas of your body. The term blood pressure comes from the blood that pushes against your arteries’ walls while they are in movement. 

Based on your body’s natural rhythms, your blood pressure may rise and fall over the day, but it’s essential to maintain healthy fluctuations. If your blood pressure stays too high for too long, it can ultimately affect your heart and create lasting damage to your body. When your blood pressure is consistently high it is known as hypertension.

Blood pressure measures have two parts.

  • Systolic blood pressure takes the measurement during a heartbeat. This is the first number listed in your reading.
  • Diastolic blood pressure measures the pressure when your heart is at rest. This is the second number listed in your reading. 

A measurement of 120/80 mmHg would be read as “120 over 80” and would translate to 120 systolic and 80 diastolic blood pressure.

The CDC shows these numbers as the healthy levels for blood pressure. 

Blood Pressure Reading Chart 

Blood Pressure CategorySystolic Blood PressureDiastolic Blood Pressure
Normal120 mm HG and lower80 mm HG and lower
Elevated120-129 mm HG80 mm HG and lower

Hypertension Reading Chart

StageReadingAlternate Reading
Stage 1130-139 mm HG80-89 mm HG
Stage 2140 mm HG or higher90 mm HG or higher

If you have high blood pressure, it can also cause complications in other parts of the body, impacting your heart, brain, kidneys, and eyes. 

There are two types of hypertension, primary and secondary. Primary is the most common among adults because there is no specific cause and the increase in blood pressure happens gradually over the years.  While secondary can be linked to an underlying condition or medication, and the increase in blood pressure is sudden and more significant.

The Mayo Clinic lists some of the conditions associated with with secondary hypertension:

  • Obstructive sleep apnea
  • Kidney disease
  • Adrenal gland tumors
  • Thyroid problems

The organization also lists medications such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs can cause secondary hypertension. Illegal drugs can also trigger this condition.

Most Common Sleep Problems That Impact Blood Pressure

Four sleep problems are commonly associated with high blood pressure:

Insomnia

Insomnia is a condition that prevents you from falling asleep and achieving uninterrupted sleep. Now it turns out that it could be to blame for high blood pressure, too.

In a groundbreaking 2015 study, Chinese researchers found that those who took an average of 14 minutes longer to fall asleep increased their chances of high blood pressure by 300 percent. Research since then continues to support these remarkable findings, blaming the inability to fall and stay asleep as a driving cause for hypertension. 

Obstructive sleep apnea (OSA)

Obstructive sleep apnea, or OSA, is a condition where your sleep is marred by jagged, halted breathing. This causes the oxygen levels to drop suddenly, increasing your blood pressure and putting more strain on your heart.

“With sleep apnea, there is a huge body of evidence that it leads to high blood pressure,” explains Dr. Meghna Mansukhani, Co-Director of the Center for Sleep Medicine at the Mayo Clinic. “We call it a dose-response relationship, meaning the worse the sleep apnea, the higher the blood pressure.”

Restless leg syndrome (RLS)

Researchers estimate that 7% to 10% of all Americans live with restless leg syndrome or RLS. Plagued by uncontrollable twitches, itches, and sensations in the legs, it’s rare for those with RLS to experience deep, uninterrupted sleep. 

More than 80% of people with RLS experience involuntary movements in their sleep as often as every 15 to 40 seconds. Burgeoning data suggests that RLS is also related to hypertension

Sleep deprivation

Research shows that your chances of developing high blood pressure increase significantly when you receive less than seven hours of sleep each night.

The correlation between sleep apnea and high blood pressure is well-documented in several medical journals. However, there are still gaps to understand how neurological sleep disorders, such as RLS, are affected by high blood pressure. 

How Can a Lack of Sleep Cause High Blood Pressure

We often don’t place enough emphasis on sleep, but it truly is the magic cure for many physiological issues. Experts recommend that adults receive a minimum of seven hours of sleep each night, but more than one-third of Americans report consistently failing to meet this recommendation. Studies show again and again that the less you sleep, the more likely you are to have high blood pressure. And it can make a bad problem even worse for those who already have high blood pressure.

The Heart Association reports that insufficient sleep or even poor sleep quality can contribute to several issues, such as weight gain, and can even affect your brain’s ability to function.  It can also cause hormonal fluctuations that keep your blood pressure high rather than helping to regulate it.  With high blood pressure, your heart is constantly working, forced to work harder against the arteries’ extra pressure and resistance. When you don’t rest at night, you don’t give your heart a chance to relax and your body to mend. 

According to studies, adults who sleep less than seven hours each night are more likely to face the following medical issues:

  • Heart attack
  • Heart disease
  • Asthma
  • Depression
  • Stroke
  • Obesity
  • Type 2 Diabetes

Sleep can help alleviate some of these conditions, but first, you have to sleep, and it’s not so easy for everyone these days.

The Connection Between Stress and High Blood Pressure 

Stress has significant effects on the body and your blood pressure especially. The rush of adrenaline that comes from a stressful situation produces a sudden surge of hormones that cause your heart to beat faster. This also impacts your blood vessels, causing them to narrow in response and increase pressure on your arteries.  

It’s all interconnected. When you sleep well, you can better manage your stress and thus reduce your heart’s strain. When you stress less, you can sleep better. Either way, your health improves, which is why it’s so important to take an inventory of your life and make adjustments quickly when you begin noticing trouble in either area.

Common Stressful Events

Life today is full of stressors that can impact each day, and the coronavirus pandemic has continued to deliver uncertainty in a world already too full of hidden dangers. From job losses, wage reductions, and business closures, COVID has taken the American economy on quite a ride, and Americans have had no choice but to strap in and endure. 

Life in 2021 has taken on a new form, one borne of home-based school, work, and social lives, as we mourn the loss of not only the freedom we used to enjoy but also the family and friends we have lost along the way. While everyone’s worries are different, there are some common stressors that we all share today that can impact our health and how we sleep at night. 

The Holmes-Rahe Stress Scale is a helpful tool designed to help patients gauge their stress levels. It can also show a person’s risk of developing a chronic illness, such as hypertension.  

The Holmes and Rahe Stress Scale points out that these 20 stressful events have the most impact on your sleep and blood pressure. They are noted by a measure of stress, indicated by the scale’s “Life Change Unit.”  

Life EventStress Rating (Life Change Unit)
Death of spouse100
Divorce73
Marital separation65
Detention in jail or other institution63
Death of a close family member 63
Major personal injury or illness 53
Marriage50
Being fired at work47
Marital reconciliation45
Retirement from work 45
Major change in family member’s health or behavior44
Pregnancy40
Sexual difficulties39
Gaining a new family member39
Major business readjustment39
Major change in financial state38
Death of a close friend37
Changing to a different line of work36
Major change in the number of arguments with spouse35
Taking on a mortgage31

Interpreting Your Score

The American Institute of Stress offers guidance on the Holmes-Rahe Stress Scale, including how to interpret your score. 

A score between 11- 150 means that you have a low to moderate chance of future illness, but anything over 150 becomes more serious. When you have a score between 150 and 299, your chance of becoming ill in the near future is moderate to high, while a score of 300 to 600 means there is a high or very high risk.

We’ve adapted our very own stress inventory worksheet, included as a downloadable file below, so you can begin to take stock of the stressors that are impacting your health. Download yours here! Your ability to reduce stress will not only help you count sheep at night, but it can also help to keep you healthy and fight future illness.

Symptoms of Stress and Their Impact on Sleep

Stress doesn’t always show itself right away. It may start slowly and quietly, revealing itself as a headache, upset stomach, or just good, old-fashioned fatigue. Your mental health can become affected as depression and anxiety begin to take over. All of that stress starts to build up over time until suddenly, there’s no ignoring it anymore. Often, your sleep can be the biggest victim.

Sleep is a chance for the body to rest and regenerate, recharging for the next day to come. Our bodies are only able to survive so long without the opportunity for rest, and a lack of sleep can significantly impair the body’s systems and the way they can work together to keep the body going. 

Stress has long been known as a significant deterrent to a healthy night’s rest, and if left untreated, the body will slowly give way over time. It opens the door to other, more severe issues like depression, weight gain, skin problems, decreased sex drive, and heart disease. 

Thankfully, there are ways to help.

How To Combat High Blood Pressure Without Medication

Hypertension isn’t a situation that develops overnight, so it’s not realistic to think that it will just vanish overnight, either. It takes some time to combat such ingrained issues like stress and sleep conditions, but with some focus and a routine, you can work towards a healthier lifestyle before high blood pressure takes its toll. 

Some scientifically-backed ways to combat high blood pressure without the use of medication include:

Diet/Nutrition

Watching what you eat can have an enormous impact on your sleep, stress, and blood pressure.  The Mayo Clinic offers its DASH diet, an acronym for Dietary Approaches to Stop Hypertension. Under this dietary plan, you should reduce all sodium. The DASH diet also encourages nutrient-rich foods that include lots of potassium, calcium, and magnesium. 

Following this diet could reduce your systolic blood pressure by up to 14 points, significantly impacting your sleep and overall health. In addition to lowering your blood pressure, the DASH diet can also help prevent osteoporosis, cancer, heart disease, stroke and diabetes. 

Exercise

The American Heart Association reports that people who exercise at least four hours each week are 19% less likely to have a high blood pressure than those who are less active. Cardiovascular and aerobic exercise can make a tremendous difference in your health and help lower your blood pressure. 

A brisk walk each morning or after work can help lower your blood pressure, reduce your weight, and prepare you to sleep better. Hiking, jogging, bicycling, and swimming are great forms of exercise, while other fun ways to work out include team sports, dance classes, and even fitness challenges, games, or contests.

CBT

Cognitive and behavior therapy is a common substitute for medication in patients with high blood pressure. It has proven successful in reducing blood pressure by focusing on the cause of your stress and working to reduce it so you can sleep and function better in your daily life. By learning ways to manage our stress more effectively, we also treat our bodies to a long-overdue period of rest where it doesn’t have to maintain that Fight-or-Flight instinct that stress creates.  

Naps

Research shows that a daytime siesta could make an enormous difference in your health. Some studies even suggest that your midday reprieve can help you maintain lower blood pressure, with your systolic pressure decreasing by an average of 3 mm HG for every hour that you nap.

Dr. Manolis Kallistratos, a cardiologist at Asklepieion General Hospital in Voula, Greece, explains, “Midday sleep appears to lower blood pressure levels at the same magnitude as other lifestyle changes. “These findings are important because a drop in blood pressure as small as 2 mm Hg can reduce the risk of cardiovascular events such as heart attack by up to 10 percent.”

While these methods have been effective for many living with high blood pressure, it’s also important to know that each body is different and may experience separate reactions. You should always consult the advice of a qualified, licensed, and experienced medical professional who can offer the appropriate guidance based on your specific case. These professionals can also advise on significant lifestyle or diet changes that can impact your health.

Bedtime Tips for Easing Stress

In addition to your new daytime tips, there are some new bedtime rituals that you can institute each night to rest more soundly. 

Guided meditations

You can listen to guided meditations before bed to help you wind down mentally and prepare the body for rest.

Deep breathing exercises

Practice deep, even breaths after getting into bed. Concentrating on your breathing will keep the mind occupied on a positive, non-threatening activity, while steady breathing helps the body wind down for sleep. 

Stretching

Stretching can help you relax tense, tangled muscles, so you are more comfortable when you finally sprawl out in bed. A quick stretch before bed can provide oxygen to the blood, increase blood flow, and act as a natural aid to help cure those aches and pains so you can sleep better. Back pain is a common cause of poor night’s sleep, but sometimes, all you need is a great mattress to help you sleep better at night. 

Add a calming soundtrack

Music has long been linked to a series of health benefits, and blood pressure is no different. Classical music, in particular, has shown notable effects in reducing stress levels and improving the quality and duration of sleep when played before bed. Before you turn the lights out, consider a little Mozart to help whisk you away to dreamland.

Enjoy an evening massage

You don’t need a professional to enjoy the health effects of a massage at home. Consider the use of an affordable foam roller to use each night before bed. Not only will you benefit from the added relaxation, but long-term studies also show that a consistent massage program can decrease both your diastolic and systolic blood pressure.

Other helpful tips

  • Create a regular sleep routine and stick to it. 
  • Spending time outside in natural light.
  • Make time for physical activity each day.
  • Avoid artificial and blue lights before and around bedtime.
  • Limit all food and drink a few hours before bedtime.
  • Make your room a comfortable space for sleep.

Your healthcare professional can also offer specific tips based on your health and medical history.

Too Long, Didn’t Read?

Research shows, again and again, that blood pressure is directly related to critical lifestyle factors like stress and sleep, but it is possible to turn things around. A few key tips and some minor changes are all it takes to give your body a renewed lease on life in many cases. While high blood pressure should always be taken seriously, you can treat it very effectively with lifestyle changes. Always check with your doctor as uncontrolled or persistent hypertension may need medication in addition to lifestyle changes. The end goal is that you can lower your stress, sleep better and live a healthier and happier life.