Nighttime blood pressure is a crucial indicator of hypertensive or cardiovascular disorders. If you have elevated blood pressure readings during sleep, read on to learn more.
Quick Summary
- Nighttime blood pressure spikes indicate severe cardiovascular health issues in those with normal blood pressure levels during the day.
- Nighttime blood pressure can be controlled using a combination of medications and lifestyle changes suggested by your doctor.
- The nighttime blood pressure increase is dangerous if the systolic reading is 20 mmHg or more compared to the daytime blood pressure reading.
- Nighttime spokes in blood pressure increase the risk of strokes, heart attacks, and heart failure.
Sleep time is essential for the human body as the human body performs vital functions during the state of rest. However, that’s not always the case.
Blood pressure follows a unique pattern. It begins to rise after a person wakes up and continues to rise throughout. It peaks during midday, and it begins to drop around late afternoon and evening.
Ideally, blood pressure should be low or normal around nighttime, especially when it is time to sleep.
Most people have fluctuating blood pressure while they sleep. These blood pressure spikes can be dangerous in some cases. Irregular blood pressure can show up as the following:
- High blood pressure in the early morning hours.
- High blood pressure during the nighttime.
- Around a 10% drop in blood pressure overnight as the person sleeps.
This condition is known as Nocturnal Hypertension. According to a study by Circulation, individuals with increased blood pressure while sleeping are at risk of heart failure and other unwanted cardiovascular diseases.
This condition can occur in anyone, even those with normal daytime blood pressure. It is a complex condition to monitor, and routine daily checks are recommended.
Daytime vs. Nighttime Blood Pressure
Multiple researchers have expressed that recording daytime and nighttime blood pressure readings separately can reveal prognostic information about a patient’s hypertension.
This may be attributed to different activity levels, daily routines, and comorbidities like kidney issues, diabetes, or thyroid irregularities.
Nighttime blood pressure is a crucial predictor of cardiovascular risks like heart disease and strokes.
For example, if the systolic blood pressure increases by 20 mmHg or more during nighttime, the risk of heart disease and strokes rises by 18%, and the risk of heart failure increases by 25%.
On the other hand, if the nighttime blood pressure readings drop by 20%, the risk of a stroke is doubled.
In short, nighttime blood pressure spikes indicate severe cardiovascular problems and require immediate medical attention and intervention.
Causes of Spikes in Blood Pressure at Night
Blood pressure increase during daytime is a natural process. It indicates that the body is excreting excess sodium from the kidneys.
However, in individuals with high circulating blood volume, blood pressure spikes at night are common to continue removing sodium. This comes with a risk to heart health.
According to Dr. Raymond Townsend from the American Heart Association and the University of Pennsylvania, the “purest time for blood pressure” is at night. This is because it provides a “window into how that person’s system is working.”
Dr. Townsend recommends using at-home devices to monitor nighttime blood pressure. The device is called WatchBP Home and is manufactured by Microlife, providing patients with three nocturnal readings.
Health Risks Associated with Elevated Nighttime Blood Pressure
A Japanese study observed over 6,000 individuals who wore portable monitors to measure nighttime and daytime blood pressure.
The participants had one cardiovascular risk factor, and the majority were taking medication to control hypertension.
After 2-year and 7-year follow-ups, the researchers found:
- Those with high nighttime systolic blood pressure (over 20 mmHg) were at risk for atherosclerotic cardiovascular issues and heart failure.
- Those who took medication were at risk for stroke if nighttime blood pressure fell.
- 306 events were reported; 119 strokes, 88 diagnoses of heart failure; and 99 diagnoses of coronary artery disease.
The study was essential in pointing out the importance of monitoring nighttime blood pressure in patients diagnosed with hypertension and at risk of developing cardiovascular issues.
Prevention of Nighttime Blood Pressure Spikes
Various other medical and psychosomatic conditions and lifestyle factors can increase the risk of nocturnal blood pressure spikes. Some of these conditions are:
- Diabetes
- Thyroid problems
- Kidney issues
- Sleep apnea
- Poor sleep quality
- Obesity or being overweight
- Autonomic nervous system dysfunction
- Sympathetic nervous system activation
- Mental health disorders like anxiety or depression
- Work patterns like night-shift jobs
- Smoking
- Excessive use of alcohol
- Not taking medication on a schedule
It is essential patients adopt measures to lower their blood pressure. Experts recommend:
- Make dietary changes like reducing salt intake.
- Using diuretics and mineral corticoid receptor blockers under your doctor’s supervision to regulate nighttime blood pressure.
- Maintaining a healthy and consistent sleep schedule.
- Avoiding alcohol and caffeine close to bedtime.
- Avoiding blue light devices like mobile phones, tablets, and television.
- Seeking help for stress, like psychotherapy or psychiatric intervention.
- Incorporating stress-reducing movements like exercise, yoga, and deep breathing.
Individuals with pre-existing hypertensive conditions should seek their doctors’ advice before incorporating medicinal or lifestyle changes to manage their condition. For example, doctors are now suggesting alternatives to lower blood pressure.
Conclusion
To monitor spikes in nighttime blood pressure, physicians usually prescribe a 24-hour monitoring test. This is called the ambulatory blood pressure monitoring test, and it provides a detailed report about an individual’s blood pressure readings throughout the day and night.
It gives physicians an idea of what may be causing the high blood pressure readings at night, and a course of medication and lifestyle changes are prescribed to help patients monitor their cardiovascular health.
If you experience fluctuations in your nighttime blood pressure readings, get in touch with your physician immediately.
References
“Abnormal blood pressure levels while sleeping increase risk of heart disease, stroke.” Heart.org (2020). https://newsroom.heart.org/news/abnormal-blood-pressure-levels-while-sleeping-increase-risk-of-heart-disease-stroke
Kario, K et al. “Nighttime Blood Pressure Phenotype and Cardiovascular Prognosis.” Circulation 142 (2020): 1810-1820. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049730
Fagard, R. H et al. “Daytime and Nighttime Blood Pressure as Predictors of Death and Cause-Specific Cardiovascular Events in Hypertension.” Hypertension 51 (2008): 55-61. https://www.ahajournals.org/doi/full/10.1161/hypertensionaha.107.100727
Kario, K et al. “Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives.” Hypertension 38.4 (2001): 852-857. https://pubmed.ncbi.nlm.nih.gov/11641298/
Casagrande, M et al. “The Night Side of Blood Pressure: Nocturnal Blood Pressure Dipping and Emotional (dys)Regulation.” International Journal of Enviromental Research and Public Health 17.23 (2020): 8892. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729863/
Robin Backlund is a dedicated journalist and a medical student who has written several articles and essays exposing the falseness and hollowness of online resources in the medical science niche.