Key takeaways

  • Sleep apnea and high blood pressure are often related, with each condition increasing the risk of the other.
  • When you have sleep apnea, the momentary drops in blood oxygen can impact how well your heart functions.
  • Treatments like CPAP machines, medications, and lifestyle changes can help manage both sleep apnea and high blood pressure.

The heart and lungs have a close relationship, and problems with one can lead to problems with the other.

For example, sleep apnea and high blood pressure often go hand in hand, and each condition is considered a risk factor for the other.

Treatments, including at-home and prescription-basesd, can help you effectively manage both.

High blood pressure (hypertension) happens when your heart and blood vessels work harder than they should.

People with obstructive sleep apnea (OSA), one type of sleep apnea, are more likely to develop hypertension than the general population. And people with hypertension may be more likely to develop OSA than others.

Research from the American Heart Association (AHA) suggests that over 50% of people with OSA may have high blood pressure, while 30% to 50% of people with high blood pressure may have OSA.

In people without OSA, blood pressure levels typically fall during the night, a process called “dipping.”

In people with OSA, blood pressure levels often rise and fall throughout the night. Blood pressure increases momentarily when your airway is blocked and decreases when your airway opens.

The severity of OSA and hypertension may also play a role. A 2020 research review suggests that about 75% of people with hypertension resistant to traditional treatments may also have underlying sleep apnea.

With OSA, your airway becomes blocked while you’re asleep.

When you stop breathing, even for a moment, the level of oxygen in your blood drops (hypoxia), while carbon dioxide levels increase. This can impact how well your heart contracts and pumps blood to the tissues in your body.

Blocked airways can also cause snoring and continuous wake-ups. A 2018 research review links sleeping less than 5 hours a night or having frequent sleep interruptions to increased blood pressure.

OSA can cause other effects that may contribute to hypertension, including:

  • whole-body inflammation
  • metabolic disruptions
  • increased activation of your sympathetic nervous system
  • oxidative stress

Both hypertension and OSA can develop as a result of shared risk factors such as:

  • atherosclerosis
  • vascular injuries
  • abnormal vasoconstriction
  • changes in adrenal levels

Continuous positive airway pressure (CPAP) is a standard treatment for sleep apnea.

A CPAP machine delivers a steady stream of air pressure through your nose or mouth while you sleep, keeping your airway open and preventing obstruction that may wake you up.

A 2021 study of 918 Japanese participants that lasted 2 years demonstrates that CPAP use may help treat sleep apnea and slightly lower daytime blood pressure levels.

If you receive a diagnosis of sleep apnea, a healthcare professional may prescribe a CPAP machine. Specialty service suppliers who work with insurance providers supply the machine.

Most insurance providers cover CPAP machines as long as you have a prescription. Medicare also covers CPAP machines.

Starting CPAP therapy checklist

  • Receive a prescription from your doctor and choose a machine. They’ll teach you how to use it properly once it arrives.
  • Check with your insurance provideror Medicare to determine CPAP machine coverage.
  • Ask your insurance provider about coverage for additional machine accessories such as masks, tubing, and cleaning supplies.
  • Find out how to set up maintenance or delivery of additional supplies.
  • Arrange for follow-up visits with your doctor to discuss the effectiveness of your CPAP therapy.

CPAP therapy alone often isn’t enough to treat hypertension, regardless of which condition you developed first.

But it is often sufficient to treat sleep apnea and may subsequently help lower your blood pressure slightly. Still, you may need additional treatments.

Medication

Many different medications can help treat hypertension. For example:

ACE inhibitors and ARBs are often first-line treatments for hypertension.

The FDA approved the first medication for moderate to severe OSA in 2024, and more are expected to hit the shelves in the future.

Other treatments

Lifestyle changes can also be effective for both sleep apnea and hypertension. These include:

Surgeries, such as tonsil removal (tonsilectomy), can help unblock obstructions that may contribute to sleep apnea. Talk with a healthcare professional about whether surgery is a realistic option for you.

Do you still have hypertension when you wake up?

Blood pressure changes caused by sleep apnea don’t necessarily stop when you wake up. This is why it’s important to take steps to reduce high blood pressure, even if you use a CPAP machine.

You can reduce high blood pressure through some combination of lifestyle changes and medication.

Your heart and lungs are closely linked and depend on each other for optimal function.

If you have sleep apnea, talk with a healthcare professional about steps you can take to prevent or treat existing problems with high blood pressure. Untreated high blood pressure can lead to complications.

Take care of your health and schedule regular wellness and preventive care appointments to help identify problems with either condition early and potentially avoid more serious complications.