Nocturnal hypertension is high blood pressure that a person experiences at night. Frequently waking with the need to urinate, sleep apnea, and difficulty breathing are all symptoms of high blood pressure while sleeping.

Blood pressure typically decreases, or dips, during the night, according to a natural sleep-wake cycle called the circadian rhythm.

During the day, a person’s blood pressure should not be higher than 120/80mmHgTrusted Source. 120 refers to the systolic, or upper number, and 80 to the diastolic, or lower number. At night time, elevated blood pressure may exceed 110/65mmHgTrusted Source.

Elevated nocturnal blood pressure may contribute to many of the same complications as high blood pressure in general, such as stroke, heart attack, and kidney failure.

This article looks at the symptoms, causes, and risk factors of nocturnal hypertension, as well as the diagnosis of the condition. It also discusses treatment, prevention, and the outlook for nocturnal hypertension.

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People sometimes refer to high blood pressure, or hypertension, as a silent killer. This is because, in most casesTrusted Source, people do not experience any symptoms of the condition.

People with nocturnal hypertension may experience some disruptions to sleep, which can include:Trusted Source

  • sleep disturbances
  • nocturia, or frequently waking with the need to urinate
  • sleep apnea
  • difficulty breathing, which may cause gasping or snoring

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, high blood pressure can develop over time or can be the result of unhealthy lifestyle choices. People with general hypertension may also experienceTrusted Source nocturnal hypertension.

Typically, blood pressure decreases by 10–20%Trusted Source during the night, as it follows the natural circadian rhythm.

In people with hypertension, the blood pressure does not always decrease as far as it should, and in some cases, it increases.

Researchers associateTrusted Source various conditions with nocturnal hypertension. These may include:

It can be difficult for doctors to diagnose nocturnal blood pressure because the condition typically occurs in a person’s home while they are sleeping.

A person is also not able to wake in the night and measure their blood pressure, as the readings may change when the person wakes.

To obtain a diagnosis of nocturnal hypertension, a person may needTrusted Source to wear an ambulatory blood pressure monitoring cuff overnight. This tests and monitors blood pressure intermittently and can provide an accurate pattern of a person’s blood pressure.

The treatment for nocturnal hypertension is similar to that of hypertension in general.

Doctors may recommendTrusted Source lifestyle changes, such as reducing sodium intake, to lower blood pressure levels.

They may also suggest antihypertensive medications or medication to treat conditions associated with hypertension, such as sleep apnea or diabetes.

However, to treat nocturnal hypertension, a doctor may recommend that a person takes their medication later than usual or takes further doses during the night.

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To help prevent high blood pressure in general, the CDCTrusted Source recommends:

  • Eating a healthy diet: A person may benefit from following the DASH diet, which is rich in magnesium, protein, fiber, calcium, and potassium and low in sodium.
  • Being physically active: Adults should engage in moderate-intensity exercise for at least 2 hours and 30 minutes per week.
  • Getting enough good quality sleep: Lack of quality sleep can contribute to hypertension, heart disease, and stroke.
  • Avoiding or limiting alcohol consumption: Excessive alcohol can increase a person’s blood pressure.
  • Stopping smoking: Smoking raises a person’s blood pressure and increases their risk of heart attack, stroke, and other illnesses.

According to a 2020 articleTrusted Source, nocturnal hypertension can lead to several complications, which include:

  • all cardiovascular events, such as heart attacks and heart disease
  • organ damage, such as kidney failure
  • stroke
  • diabetes

There is no cure for high blood pressure, but treatment can help people manage their symptoms and reduce the risk of complications. In mild cases, healthy lifestyle choices may bring the condition under control.

A person should contact a doctor if their blood pressure exceeds 180/120mmHgTrusted Source during the day and does not decrease after rest.

Nocturnal hypertension may not have symptoms. However, if a person experiences poor sleep or has a condition associated with nocturnal high blood pressure, a doctor may wish to check their blood pressure levels.

Below are the answers to some frequently asked questions about nocturnal hypertension.

Is nocturnal hypertension dangerous?

Yes, nocturnal hypertension may contribute to various severe health complications, such as heart attack and stroke. If a person is concerned about having nocturnal high blood pressure, they should speak with their doctor.

Can stress cause nocturnal hypertension?

Stress may leadTrusted Source to other risk factors for hypertension, such as excessive alcohol consumption or a poor diet. However, more research is necessary to determine whether stress contributes directly to long-term high blood pressure.

Stress can cause a release of adrenaline, which can temporarily raise blood pressure, but these effects are typically short-term.

Blood pressure usually decreases during the night, according to a person’s circadian rhythm. In people with nocturnal hypertension, blood pressure does not decrease enough or sometimes rises.

Potential risk factors for nocturnal hypertension include sleep apnea, kidney disease, and diabetes. If a person does not treat nocturnal hypertension, they may be at higher risk of various health complications, including heart attack and stroke.

To receive a diagnosis of nocturnal hypertension, a person may need to wear an ambulatory blood pressure monitor. Treatment may include medication and lifestyle changes.