Sleep is a multi-dimensional health behavior. Sleep disturbances may result from several sleep behaviors, presence of obstructive sleep apnea (OSA) and general sleep hygiene. Hypertension or the sustained increase in blood pressure has clinically been shown to have a bidirectional relationship with sleep quality.
Short sleep, shift work and OSA are all associated with hypertension risk. OSA in nature, caused by a collapse in the upper airway during sleep leading to transient asphyxia or choking, decrease in blood oxygen levels and daytime sleepiness is a key risk factor in people with hypertension. The prevention and treatment of OSA is considered a possible target for lowering the risk of cardiovascular disease.
People with OSA generally present with lower diet quality in conjunction with decreased physical activity, adversely shift workers are more prone to short sleep patterns and increased nocturnal awakenings. This habitual short sleep and shift work can increase hypertension risks by disrupting circadian rhythmicity. This disruption can potentially cause a cascade of desynchronies and metabolic dysfunctions that have a direct effect on blood pressure and predispose hypertension.
Finally, sleep disturbances may increase hypertension risk via their influence on psychological factors, including depression and anxiety. Indeed, a bidirectional association likely exists between sleep and depression and anxiety. Depression and anxiety have, in turn, been linked to reduced nighttime BP dipping, higher BP, and greater risk of prevalent and incident hypertension.
