Hypertension, or high blood pressure, is a frequent condition in which the power required to circulate blood through the body’s blood arteries is excessive. Many people with hypertension don’t experience any noticeable symptoms until they get their blood pressure checked. Uncontrolled high blood pressure increases the risk of stroke, heart disease, and other cardiovascular complications. Fortunately, the risks associated with hypertension can be mitigated by the use of medication and adjustments in lifestyle.
The sleep disorder known as sleep apnea is characterized by periodic stops in breathing while sleeping. Occlusive sleep apnea (OSA) and central sleep apnea (CSA) are the two main categories of this disorder (CSA). Snoring and gasping during sleep are common symptoms of obstructive sleep apnea (OSA), which is characterized by episodes of airway collapse that limit airflow into the lungs. The inability of the brain to properly instruct the muscles responsible for breathing is what causes respiratory gaps in CSA.
When a person has both hypertension and sleep apnea, treating the latter can help reduce the former’s effects on blood pressure.
What is Hypertension?
When the force of your blood pushing against your arterial walls becomes too great, you have hypertension. As a result, your heart muscle becomes overworked and exhausted, preventing it from performing at its best.
Hypertension comes in a wide variety of forms, some of which are:
- High Blood Pressure in the Lungs/Arterial Hypertension in the lungs (PAH)
- Hypertension with No Clear Cause
- Hypertension in the System
- Stubborn Hypertension
You’ve probably had your blood pressure taken before, and you know the uncomfortable feeling of having your arm squeezed tightly while the machine records your readings. Your systolic blood pressure is the top number and your diastolic blood pressure is the bottom number on your results.
- When you take your blood pressure, the first number, the systolic, shows how much pressure your blood is putting on your arteries at the time your heart is beating.
- The time between heartbeats is quantified by your diastolic blood pressure.
Even while it’s natural for your blood pressure to rise and fall during the day, a reading of hypertension or higher than 120/80 on many occasions is not healthy and may signal hypertension and other issues.
How Hypertension Affects Your Body
Annually, high blood pressure causes the deaths of hundreds of thousands of people worldwide and is a contributing factor in about half a million deaths in the United States alone. The Center for Disease Control reports that 32.6-38.6% of Tennesseans aged 20 and up have hypertension, which is a very high prevalence.
Hypertension can cause heart damage and other serious health problems if it is not addressed, and it can even cause death if left untreated. Several examples of this are:
- Coronary Artery Disease
- Arrhythmia of the Atrium
- The risk of cardiac arrest or failure
- Inability to See
- Renal Disease / Kidney Failure
Risk Factors for Hypertension
In addition to gender and family history, advanced age is also a major contributor to the development of hypertension. And despite hypertension’s prevalence among American adults, there are no outward manifestations of the disease. That’s why some people refer to it as “the silent killer.”
Diseases of the cardiovascular system, including heart disease, heart failure, stroke, and erectile dysfunction, are all linked to hypertension. Sleep apnea, or sleep disrupted breathing, has been linked to several illnesses. Anyone experiencing high blood pressure might benefit from a sleep test, as studies show that up to half of those with hypertension also have sleep apnea.
The good news is that hypertension can be effectively treated with a combination of a nutritious diet, regular exercise, and proper sleep hygiene. Getting a sleep test to determine if undiagnosed sleep apnea is vital if your hypertension does not react well to these lifestyle modifications or medication.
The Relationship Between Sleep Apnea and Blood Pressure
OSA is the only kind of sleep apnea associated with hypertension. Though it is unclear why CSA occurs in up to half of those who suffer from heart failure, it is a major contributor to the development of high blood pressure.
OSA affects 30–40% of patients with hypertension, although affecting just 4–7% of the general population. About half of those who have been diagnosed with OSA also have hypertension.
The term “blood pressure dipping” is used to describe the normal nighttime drop of 10-20% in blood pressure that occurs in healthy people. People with severe OSA have a “non dipping” blood pressure pattern, meaning their blood pressure rarely drops by more than 10%.
Increased risk of cardiovascular disease is seen in those whose blood pressure does not drop at night. Another common symptom of OSA is a sharp rise in blood pressure upon awakening in the morning. This “morning rush” could also be a contributor to an already high risk for cardiovascular disease. Death from cardiovascular disease and other causes also rises when OSA severity rises from moderate to severe.
Obstructive sleep apnea has a wider impact on blood pressure than just during sleep. It has been shown through scientific research that the more severe the sleep apnea, the higher the daytime blood pressure.
How Does Sleep Apnea Cause High Blood Pressure?
Heart stress from lack of sleep is well-documented, and obstructive sleep apnea (OSA) has been linked to elevated blood pressure due to sympathetic nervous system activation. This is the part of the nervous system responsible for the “fight or flight” reaction. When triggered, the sympathetic nervous system causes a transient rise in heart rate, blood pressure, pupil size, and metabolic rate, among other changes in the body. All of these alterations help us react appropriately to stressful situations, but prolonged sympathetic nervous system activity can cause hypertension.
The sympathetic nervous system is engaged and blood pressure rapidly rises whenever a person with OSA has airway collapse and a brief interruption in breathing during sleep. These pauses and restarts in breathing can sometimes jolt a sleeping person awake. Once a person awakens from an OSA episode, their sympathetic nervous system is even more activated and their blood pressure is higher than it was before the occurrence.
Catecholamines, hormones of the sympathetic nervous system, are also released into the blood when sleep is disrupted by OSA symptoms. Catecholamines are hormones of stress, with most of their production occurring in the adrenal glands. Catecholamines consist of many neurotransmitters including dopamine and epinephrine (also called adrenaline). The presence of excess catecholamines in the bloodstream is associated with increased blood pressure.
Obesity and Insulin Resistance
Obstructive sleep apnea (OSA), high blood pressure (BP), obesity, and insulin resistance are all interconnected in intricate ways.
Higher and higher doses of the hormone insulin are needed for people with insulin resistance so that their bodies can use glucose, a form of sugar in the blood, as an energy source. Blood glucose levels might rise uncontrollably and diabetes can develop with prolonged insulin resistance. Insulin resistance is a well-documented complication of obesity. Obstructive sleep apnea (OSA) has been proven in recent research to contribute to insulin resistance in people of all sizes. Another potential contributor to insulin resistance is hypertension. High blood pressure may be a symptom of, or contributed to by, insulin resistance due to the activation of the sympathetic nervous system that occurs with this condition.
How Does Sleep Apnea Treatment Affect Blood Pressure?
Oversleep Disordered Breathing (OSA) can be treated in several ways. Aside from easing hypertension symptoms, treatment also boosts sleep quality. Continuous positive airway pressure is the standard treatment because it works (CPAP).
Wearing a facemask connected to a machine that pushes air into the lungs at night is a key part of CPAP therapy. It helps those who suffer from OSA sleep better by preventing their airway from closing during the night. Treatment with CPAP decreases blood pressure both during the day and at night, notably in individuals with severe OSA, according to studies looking into the effects of CPAP on patients with hypertension and OSA. The catecholamine levels are likewise lowered by CPAP.
Some people have trouble sleeping while using a CPAP mask. To successfully manage OSA and hypertension, regular, appropriate CPAP use is crucial. As an alternative to CPAP, mouthpieces also work to keep the airway open while you sleep. There needs to be more investigation into whether or whether patients with high blood pressure and OSA can also benefit from using mouthpieces to reduce their blood pressure. In addition, several surgical treatments are used to treat OSA in certain patients.
Managing OSA may also involve reducing blood pressure by losing weight, which can be done through dietary and lifestyle modifications or surgical procedures.
Should I Talk To My Doctor About Sleep Apnea?
Get checked out by a doctor if you have hypertension and suspect you may possibly have sleep apnea. The first step toward obtaining OSA therapies that may help sleep and blood pressure is a diagnosis. Think about whether any of these symptoms seem familiar:
- Daytime drowsiness
- Problems focusing and remembering
- Morning head aches, to be specific
- Lack of saliva upon awakening
- Distress, nervousness, or melancholy
People with sleep apnea frequently deny that they have the condition. Nighttime OSA symptoms are often first noticed by a bed partner, who then seeks medical attention. If you live with other people, you may want to find out if they have seen any of these behaviors from you while you were asleep:
- Roaring snores
- Sleep-related choking and gasping
- sleep breathing interruptions
If you or a loved one are experiencing any of these signs, it’s important to discuss your sleep habits with your doctor.
Vote on this comment!