Sleep Apnea and High Blood Pressure: The Connection Explained
Why treating your sleep apnea may be the key to controlling your blood pressure
If your blood pressure won't come down despite medication, sleep apnea may be the hidden cause. About 30–50% of people with high blood pressure also have obstructive sleep apnea. For those with treatment-resistant hypertension, that number jumps to 75%. Treating sleep apnea can significantly lower blood pressure — sometimes enough to reduce or eliminate medication.
- 30–50% of hypertension patients have undiagnosed sleep apnea
- 75% of treatment-resistant hypertension is linked to OSA
- Each apnea episode triggers a blood pressure spike from oxygen deprivation
- Treating sleep apnea can reduce systolic BP by 5–10 mmHg
- Even mild sleep apnea affects blood pressure over time
How Sleep Apnea Raises Blood Pressure
The connection is biological, not coincidental. Here's what happens inside your body:
The Oxygen Drop Cycle
Every time your airway closes, oxygen levels fall. Your brain detects the danger and floods your body with stress hormones (adrenaline, cortisol). These hormones constrict blood vessels and spike your heart rate. Blood pressure surges.
This happens dozens of times per hour, all night long. Over months and years, these repeated surges cause lasting changes to your blood vessels and nervous system.
Loss of the Nighttime Dip
Normally, blood pressure drops 10–20% during sleep. This "dip" lets your heart and blood vessels rest. Sleep apnea prevents this dip. Your cardiovascular system never gets a break.
People with OSA often have a "non-dipping" blood pressure pattern, which is an independent risk factor for heart attack and stroke.
Chronic Inflammation
Repeated oxygen drops cause oxidative stress and systemic inflammation. This damages the lining of blood vessels over time, promoting atherosclerosis (hardening of the arteries).
Signs That Sleep Apnea May Be Raising Your Blood Pressure
- Your blood pressure is high in the morning (when it should be lowest)
- Medication isn't controlling your blood pressure well
- You need 3 or more medications to manage your blood pressure
- You snore loudly or your partner notices breathing pauses
- You feel tired during the day despite sleeping enough
- Your neck circumference is above 43 cm (men) or 38 cm (women)
If your blood pressure stays high despite taking 3 or more medications, ask your doctor to screen you for sleep apnea. This is the single most overlooked cause of resistant hypertension.
How Treating Sleep Apnea Lowers Blood Pressure
When you treat sleep apnea effectively, the nightly oxygen drops stop. Stress hormones normalize. Blood vessels can relax. The results:
- Systolic blood pressure typically drops 5–10 mmHg with consistent treatment
- The nighttime blood pressure dip can be restored
- Some patients reduce or eliminate blood pressure medication
- Cardiovascular risk decreases over time
The effect is strongest in patients who use their treatment consistently every night for at least 4 hours.
Treatment Options
- CPAP: Most studied for blood pressure reduction. Works well when used consistently.
- Nasal stent: The Back2Sleep nasal stent reduces breathing events that cause oxygen drops. CE-certified for mild to moderate OSA.
- Oral appliance: Effective for mild to moderate cases.
- Weight loss: Reduces both blood pressure and AHI. Read about weight and sleep apnea.
The Bigger Cardiovascular Picture
High blood pressure is just one part of how sleep apnea damages your heart. OSA also increases the risk of:
- Coronary artery disease — plaque buildup in heart arteries
- Heart failure — the heart weakens from constant strain
- Atrial fibrillation — irregular heartbeat, common in OSA
- Stroke — 2–3x higher risk with severe OSA
Learn more about snoring and heart health and oxygen levels during sleep.
What to Do Next
- Screen yourself: Take our free sleep risk assessment
- Talk to your doctor: Ask about sleep apnea screening, especially if your blood pressure is hard to control
- Get tested: A home sleep test can confirm whether you have OSA
- Start treatment: Don't wait. Every untreated night adds to the cardiovascular burden
Frequently Asked Questions
Can sleep apnea cause high blood pressure?
Yes. Sleep apnea causes repeated oxygen drops that trigger stress hormones and blood pressure spikes. Over time, this leads to sustained high blood pressure. About 30-50% of hypertension patients have undiagnosed sleep apnea.
Will treating sleep apnea lower my blood pressure?
In most cases, yes. Consistent sleep apnea treatment can reduce systolic blood pressure by 5-10 mmHg. Some patients are able to reduce their blood pressure medication after treating their OSA.
Why is my blood pressure high in the morning?
Morning hypertension is a hallmark of sleep apnea. The repeated oxygen drops during the night cause blood pressure surges. Without the normal nighttime blood pressure dip, you wake up with elevated readings.
What is treatment-resistant hypertension?
It means your blood pressure stays above target despite taking 3 or more medications. About 75% of treatment-resistant hypertension cases are linked to undiagnosed sleep apnea.
Can a nasal stent help with blood pressure?
By keeping the airway open and preventing oxygen drops, a nasal stent addresses the mechanism that links sleep apnea to high blood pressure. Consistent nightly use is key for cardiovascular benefit.
This article is for informational purposes only and does not replace professional medical advice. Snoring can be a symptom of obstructive sleep apnea, a serious medical condition. If you suspect sleep apnea, consult a healthcare professional. Back2Sleep is a CE-certified Class I medical device intended for the treatment of snoring and mild to moderate sleep apnea.
Ready for quieter nights? Discover the Back2Sleep starter kit and find the right fit for you.
Not sure if you are at risk? Take our sleep risk screening to find out in just a few minutes.
Want to learn how it works? Explore the Back2Sleep nasal stent designed for comfortable, effective relief.
