Blood pressure and sleep apnea
Is your high blood pressure hard to control with medication, and do the numbers just not seem to come down? Do you also sleep poorly and often feel tired and worn out during the day?
The problems may be caused by a condition known as sleep apnea. This involves pauses in breathing during the night, often without the affected person noticing. In most cases, spouses or partners who share a bed with the affected person can provide more information about this than the person themselves. They often have a better idea of whether their partner snores or even experiences pauses in breathing, especially after isolated snoring episodes. If this applies to you, please discuss it with your doctor.
Sleep apnea can cause or worsen high blood pressure because the pauses in breathing lead to a drop in the oxygen level in the blood. The body reacts to this situation, which it perceives as life-threatening, with a lifesaving wake-up response known as an arousal. This causes the heart rate and blood pressure to rise and the muscles to tense. The pause in breathing is then usually ended by a few deep or long breaths. Although the person does not wake up or remember it, they enter a lighter, less restorative stage of sleep. As a result, they are unaware of the nighttime pauses in breathing, but feel their effects during the day in the form of daytime sleepiness, morning headaches, forgetfulness, and mood problems.
Lower oxygen levels affect blood pressure by increasing it on average by 8 to 15 mmHg systolic and 5 to 10 mmHg diastolic, because this raises the stress hormone level and the level of the vasoconstrictor endothelin. The lack of nighttime recovery pushes blood pressure even higher.
If sleep apnea syndrome is present, the normal nighttime dip in blood pressure is often missing because of the factors mentioned. Depending on how severe the condition is, blood pressure may even rise at night.
Treating sleep apnea usually lowers blood pressure or makes it respond much better to medication.
Sleep apnea doesn't only affect adults. Due to being overweight and a lack of exercise, the condition is also becoming increasingly common in children and adolescents, increasing their risk of developing high blood pressure. Affected children often stand out because of their behavior or worsening school performance. If a child is diagnosed with obstructive sleep apnea, their blood pressure should also be checked.
Interesting:
A 2025 study in rats showed that if the body repeatedly gets too little oxygen (for example with sleep apnea), part of the nervous system becomes overactive. This can lead to high blood pressure.
This overactivity likely arises from certain signals during exhalation that stimulate the nerve cells that control blood pressure.
This overactivity likely arises from certain signals during exhalation that stimulate the nerve cells that control blood pressure.
Sources
- https://www.deutsche-apotheker-zeitung.de/daz-az/2012/daz-36-2012/schlafapnoe-als-risikofaktor-fuer-hypertonie
- https://www.aerzteblatt.de/nachrichten/125057/Schlafapnoe-kann-bereits-im-Teenageralter-den-Blutdruck-ansteigen-lassen?rt=77add3308aa7bc665b00209049c45c84
- https://jamanetwork.com/journals/jamacardiology/article-abstract/2781077
- https://pubmed.ncbi.nlm.nih.gov/41404666/
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 03/2026).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
