Effects of insufficient sleep on blood pressure in hypertensive patients: a 24-h study
Abstract
The influence of acute sleep deprivation during the first part of the night on 24-h blood pressure monitoring (ABPM) was studied in 36 never-treated mild to moderate hypertensive patients. According to a crossover design, they were randomized to have either sleep deprivation or a full night's sleep 1 week apart, during which they were monitored with ABPM. Urine samples for analysis of nocturnal urinary excretion of norepinephrine were collected. During the sleep-deprivation day, both mean 24-h blood pressure and mean 24-h heart rate were higher in comparison with those recorded during the routine workday, the difference being more pronounced during the nighttime (P < .01). Urinary excretion of norepinephrine showed a significant increase at night during sleep deprivation (P < .05). Blood pressure and heart rate significantly increased in the morning after a sleep-insufficient night (P < .05). These data suggest that lack of sleep in hypertensive patients may increase sympathetic nervous activity during the night and the following morning, leading to increased blood pressure and heart rate. This situation might represent an increased risk for both target organ damage and acute cardiovascular diseases.
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Sleep restricted to the second half of the night for one week elevates diastolic and systolic blood pressure compared to typical sleep.
“when sleep was restricted to the second half of the night for only a week, elevated diastolic and systolic blood pressure were present, compared to the week prior where a typical night of sleep was observed with no alterations(70).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [70]
Sympathetic activity is increased in sleep deprivation, restless leg syndrome, and obstructive sleep apnea.
“Sympathetic activity is also increased in sleep deprivation, restless leg syndrome, and OSA.252–254”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [253]
The mechanism of poor sleep quality contributing to elevated blood pressure and paroxysmal bouts of very high blood pressure relates to activation of both the sympathetic nervous system and the renin-angiotensin-aldosterone system.
“The mechanism of poor sleep quality contributing to elevated BP and paroxysmal bouts of very high BP relates to activation of both the sympathetic nervous system and the renin-angiotensin-aldosterone system.252–255”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [253]
Systolic blood pressure, diastolic blood pressure, and heart rate increase the day after a sleep-deprived night compared with the day after a normal sleep; urinary excretion of norepinephrine is also increased.
“SBP, diastolic BP, and heart rate increase the day after a sleep-deprived night compared with the day after a normal sleep; urinary excretion of norepinephrine is also increased.56,253–256”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [253]
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- Authors
- Lusardi, P.
- Affiliations
- University of Pavia (IT)
- Corresponding author
- Lusardi, P
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 1999-01
- Volume
- 12
- Issue
- 1
- Pages
- 63-68
- ISSN
- 0895-7061 (ISSN-L)
- OpenAlex
- W2045209949
- Cited by
- 331
- References
- 32
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 14 · 2023: 20 · 2022: 18 · 2021: 13 · 2020: 15 · 2019: 19 · 2018: 12 · 2017: 17 · 2016: 22 · 2015: 17 · 2014: 23 · 2013: 14 · 2012: 17
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep deprivation, insufficient sleep, hypertension, blood pressure, heart rate, urinary norepinephrine, sympathetic activity, 24-hour ambulatory blood pressure monitoring, nocturnal blood pressure, morning blood pressure surge, target organ damage, cardiovascular risk
- MeSH terms
- Adult, Aged, Blood Pressure, Circadian Rhythm, Creatinine, Female, Follow-Up Studies, Heart Rate, Humans, Hypertension, Male, Middle Aged, Norepinephrine, Prognosis, Risk Factors, Sleep Deprivation, Sympathetic Nervous System, Cross-Over Studies, Blood Pressure Monitoring, Ambulatory
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