Resistant hypertension is defined as blood pressure that remains above a goal target when at least three medication therapies, including a diuretic, fail to control the blood pressure. This affects an estimated 13 percent of the population with high blood pressure, also known as hypertension. For those with sleep apnea, in addition to resistant hypertension, a new study finds patients who were treated with continuous positive airway pressure (CPAP) experienced a drop in blood pressure levels.
Lead researcher of the study, Dr. Miguel-Angel Martinez-Garcia, Polytechnic University Hospital in Valencia, said in a recent article “The prevalence of sleep apnea in patients with resistant [high blood pressure] is very high.” How common? Experts estimate three out of every four people with resistant hypertension also suffer from the obstructive sleep disorder. Treating sleep apnea with 12 weeks of CPAP use can help return the nocturnal blood pressure to normal levels. Long-term benefits have not been determined for sustained improvements, health outcomes and require additional studies.
More than Sleep Apnea
Blood pressure is also connected with sleep patterns. An earlier study found sleeping less than six hours a night increases our risk of developing hypertension by 20 percent. So called “short sleepers”, experts say, activate two major stress systems - the HPA (Hypothalamic Pituitary-Adrenal system) and the Sympathomedullary system, which causes the release of stress hormones cortisol and adrenaline. While safe when needed during the day, the constant presence of these stress hormones at night can lead to resistant hypertension.
A Better Night’s Rest
A sleep study can better determine the quantity and quality of sleep you are getting at night and can also diagnose sleep apnea. For those with resistant hypertension, talk to your health care provider about a sleep study. For those having problems going to sleep or staying asleep at night, the sleep study may uncover a problem that can be treated and help reduce your risk of developing hypertension.
There are also some modifications you can make at home to help improve your sleep quality. First, set a sleep schedule and stay as close to that routine as you can every night. Go to bed at the same time each night and wake around the same time each morning. Avoid caffeine, nicotine and alcohol before you go to bed as these stimulants can prolong the onset of sleep or disrupt it in the middle of the night. Finally, create a good sleep environment. Turn off the TV, make sure the room is cool and dark and your bed is comfortable.
Oklahoma Heart Institute offers a comprehensive Resistant Hypertension Clinic. Click here to learn more.