This Habit Raises Your Risk of High Blood Pressure

• Getting adequate sleep is one of the top ways to support healthy blood pressure.
• Poor sleep duration, quality and regularity are all linked with an increased risk of hypertension.
• Stick to a regular bedtime, and limit screen time, alcohol, caffeine and nicotine to support better sleep.

Nearly 50% of Americans have high blood pressure, yet 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 conditions.

If you’re on a quest to improve your numbers but diet and exercise don’t seem to be doing the trick, your sleep habits may need some attention. “Sleep helps control blood pressure by balancing hormones, nerves and the way blood vessels work. When you don’t sleep well, your blood pressure can stay high at night and during the day,” explains David C. M. Corteville, M.D., FACC, CPE. 

In 2022, the American Heart Association updated its cardiovascular health checklist—called Life’s Essential 8—to include sleep, underscoring just how important sleep is for heart health. Keep reading to discover how better sleep can lower your risk of high blood pressure and help manage diagnosed hypertension, and learn cardiologist-recommended strategies for a good night’s sleep. 

How Sleep Affects Blood Pressure

Sleep duration—the number of hours you sleep—often gets all the attention, but it’s only part of the equation. “Different sleep variables, like how long you sleep, how well you sleep and how regular your sleep schedule is, can all affect your risk for high blood pressure, and each one matters in its own way,” says David Rizik, M.D. 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 raise your risk for high blood pressure, says Rizik. The sweet spot? Around seven to nine hours per night for adults. “Regularly getting less than seven hours, or more than nine, has been linked to a higher risk of developing high blood pressure over time.”

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

Sleep Quality

Spending seven to nine hours in bed doesn’t automatically mean it was restorative. “Poor sleep quality—like tossing, turning or waking up a lot—is strongly linked to higher blood pressure and a greater risk of developing hypertension, even if you’re technically in bed long enough,” explains Rizik. 

In one study of 33,000 adults, those who rated their sleep quality as “fairly bad” had a 22% higher risk of hypertension, while participants with “very bad” sleep quality had a 48% higher risk compared with those who reported high-quality sleep.

Sleep Regularity

When you sleep may be just as important as how much you sleep. “People whose sleep patterns vary a lot are much more likely to develop hypertension than those with a more regular routine,” says Rizik. 

The effects of irregular sleep can appear surprisingly quickly. One study of 1,600 older adults found that just one week of sleep irregularity led to elevated blood pressure—even in adults without hypertension.  Over the long term, the impact is even greater. A nine-month study of more than 12,000 adults showed that an average variation of 34 minutes in bedtime increased the risk of high blood pressure by up to 32%. In fact, the researchers noted that sleep irregularity raised hypertension risk 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. Disrupting it with irregular sleep can throw off your nervous system, placing your cardiovascular system under chronic stress.

Sleep Apnea and Blood Pressure Risk

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

“Sleep apnea is a common condition where breathing stops and starts many times during sleep,” says Corteville. He explains that these drops in oxygen put stress on the heart and blood vessels, increasing the risk of high blood pressure, especially at night. 

OSA is especially 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 health care provider if you have high blood pressure or suspect you may have OSA. Treatment options, such as CPAP machines or implantable devices, can help keep your airway open, improve oxygen levels and reduce stress on your heart and blood vessels to support healthy blood pressure. 

How to Get Better Sleep

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

• Stick to a Consistent Bedtime. “Go to bed and wake up at the same time every day, even on weekends,” advises Rizik. “This helps your body’s clock stay regular, which is linked to healthier blood pressure.”
• Adjust Your Environment. For the best sleep, make your bedroom dark, quiet and cool. Rizik suggests trying blackout curtains or a white noise machine if needed to block out disruptive light and sound.
• Limit Screens Before Bed. “The blue light from phones, tablets and TVs can mess with your body’s signal to get sleepy,” explains Rizik. Turn off screens at least 30 to 60 minutes before bedtime to allow your body to naturally prepare for sleep.
• Create a Calming Bedtime Routine. “Build a relaxing routine, like reading, gentle stretching or calm music,” suggests Rizik. “Stress can keep you awake, so anything that helps you relax can help your sleep.” Deep-breathing exercises can also help calm your nervous system.
• Choose Late-Night Snacks Wisely. “Avoid big meals, caffeine and alcohol close to bedtime,” Rizik warns. “All of these can interfere with sleep quality.” 
• Avoid Smoking. While avoiding smoking altogether is crucial for heart health, Corteville notes that smoking before bedtime can disrupt sleep, as nicotine can make it harder to fall and stay asleep. 
• Spend Time Outside During the Day. “Sunlight during the day helps set your body’s internal clock, making it easier to fall asleep at night,” notes Rizik. Try to spend time outdoors, especially in the morning. Light therapy boxes may also be helpful on cloudy days or during the winter months. 

Our Expert Take

Sleep is a powerful tool for lowering your risk of high blood pressure and managing existing hypertension. Consistent, high-quality sleep gives your cardiovascular system essential time to rest and recover each night. To improve your sleep, start with small changes: create a relaxing sleep environment, limit screens before bed, get daylight exposure and limit caffeine and alcohol. If you suspect an underlying condition like sleep apnea is affecting your sleep, talk to your health care provider about testing and treatment options.