Lauren is a board-certified adult-gerontology primary care nurse practitioner. 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 –– and only about one in four adults with the condition has it under control. Unfortunately, a lot of people don’t realize how intertwined your blood pressure and sleep health are. Just as how much sleep you get impacts your blood pressure, having high blood pressure can make it hard to fall asleep and stay asleep. 

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

How Can Lack of Sleep Cause High Blood Pressure

Experts recommend that adults sleep a minimum of seven hours each night, but more than one-third of Americans report consistently failing to meet this recommendation. Sleep deprivation 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. So 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

Your Blood Pressure While You Sleep

Sleep and blood pressure are connected. Based on your body’s natural rhythms, your blood pressure will rise and fall over the day. Although the stages of sleep each have a different effect on your blood pressure, it’s a short-term variability that’s completely normal. You’ll see a drop in your blood pressure while sleeping during the non-rapid eye movement, which is 80% of your total sleep. However, if you see spikes in your blood pressure while you sleep, that’s an indicator that something is wrong. Doctors suggest that taking your blood pressure while sleeping is actually the best representation of cardiac health.

Not being able to fall asleep is both a symptom and an amplifier of high blood pressure –– if you have trouble falling asleep, that might be a symptom of having high blood pressure. But when you have trouble falling asleep, your blood pressure stays higher for longer, which leads to a number of conditions down the line –– like heart disease or stroke.

How Sleep Supports Healthy Blood Pressure

If you already have high blood pressure, not getting enough sleep will only make matters worse. That doesn’t mean that oversleeping will cure your high blood pressure. Sleeping too much is connected to weight gain, heart disease and diabetes. 

In addition to eating better and exercising, establishing a healthy sleep routine is a way to combat high blood pressure. Change your nighttime routine to help you relax –– try adding in reading or yoga to help you get ready for bed. 

Most Common Sleep Problems Associated With Blood Pressure

Insomnia & Sleep deprivation

Research shows that your chances of developing high blood pressure increase significantly when you sleep less than seven hours of sleep each night. 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. The inability to fall and stay asleep is one of the main driving causes of hypertension. 

Obstructive sleep apnea (OSA)

Obstructive sleep apnea, or OSA, is a condition where your sleep is marred by jagged, halted breathing. The interruptions in breathing cause your oxygen levels to drop and your blood pressure to spike. Which ultimately puts 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. The frequency of the symptoms is positively correlated with an increase in blood pressure. Women with RLS have a higher chance of having hypertension

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. 

The Connection Between Stress and High Blood Pressure 

Stress has significant effects on the body and your blood pressure. 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. Sleep is a big way our body is able to respond and manage stress. 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. Unfortunately, COVID has taken the American economy on quite a ride, and Americans have had no choice but to strap in and endure job losses, wage reductions, and business closures. 

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. Add stress and sleep deprivation together and you’ve got the perfect storm of imbalance between restful sleep and blood pressure. 

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. Keep in mind that you should only add stressful events you’ve experienced in the past 12 months to generate 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 

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 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. 
  • Spend 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?

Blood pressure is directly related to critical lifestyle factors like stress and sleep. A few changes are all it takes to give your body a renewed lease on life in many cases. Depending on the severity of your high blood pressure, your doctor may recommend regulating hypertension with lifestyle changes. Always check with your doctor as uncontrolled or persistent hypertension may need medication. The end goal is to lower your stress, sleep better and live a healthier and happier life.