How Does Sleeping Affect Blood Pressure?

A lot of people are not getting the needed amount of sleep. Not only that, but they puff out their chest, proudly stating “I can get by on 5 or 6 hours of sleep.”

Well, that’s not exactly true. Just because it’s not instantly killing you doesn’t mean it’s good for you. In fact, it may be a significant contributor to your high blood pressure.

That’s what we’ll discuss in this article:

  • How bad sleep affects your blood pressure
  • The connection between sleep apnea and high blood pressure
  • Healthy behaviors that improve your sleep quality
  • Supplements for sleep

How Bad Sleep Affects Your Blood Pressure

The connection between sleep and blood pressure has been studied extensively. In one large study56, of 1741 subjects, those who slept between 5 and 6 hours per night had a 250% higher chance of developing high blood pressure compared to those who slept over 6 hours. Those who slept less than 5 hours had a 410% higher chance of developing high blood pressure.

Another very large study57 on sleep duration and hypertension, of over 700,000 people also found a strong relationship between sleep duration and high blood pressure: the less you sleep, the higher the chance of high blood pressure.

In fact, in one very interesting study aimed at sleep and its effect on blood pressure58, participants had extended their time in bed by 1 hour. Of that hour, 35 minutes were spent asleep. In 6 weeks, they lowered their blood pressure by 14/8 mmHg (oh, and they also lost 1.3% body fat in that time. Nice bonus).

Anyways, suffice it to say that sleep is very important to your health. It’s not just a passive rest. Your body and brain are hard at work normalizing body functions while you’re sleeping.

Mechanisms

We know that getting too little sleep is not good for your blood pressure, but why? There are 3 different reasons:

  1. Getting low amounts of sleep is considered to be a physically stressful condition. When you’re under physical stress, you crave more salt, according to a study59 on mental stress on various living things, ranging from mice to humans. You either go for salty snacks, or you salt your food more than when you’re not under stress. We know that salt increases water retention, which raises blood pressure.
  2. Another study60 exploring the causes of hypertension, found that getting inadequate sleep causes thickening of one of the heart walls (left ventricular hypertrophy). If the heart gets thicker and more “muscular”, it pushes blood harder. If it pushes blood harder, arteries also have to adapt by thickening as well.
  3. One more study found that inadequate sleep increases insulin levels. High insulin levels cause hardening of the arteries (that process is called “atherosclerosis”). Harder arteries require more pressure to get blood through them.
  4. To piggy back on the previous point, inadequate sleep can cause insulin resistance, according to one study. Insulin resistance is when your body doesn’t “hear” the message of insulin (insulin tells cells to “open their doors”, and let sugar out of the blood, and inside the cells). There are a number of ways by which insulin resistance leads to hypertension. You hold on to more sodium, you grow the smooth muscles surrounding the arteries (you don’t want to grow these muscles), and you have higher levels of cortisol and adrenaline.

The Connection Between Sleep Apnea and High Blood Pressure

Now that I’ve (hopefully) convinced you of the importance of sleep, what should you do? If you go to sleep late voluntarily, stop it. Listen to your mom from when you were a teenager: go to bed on time. Go to bed at the same time every night.

But if you don’t sleep well, and it’s not by choice, it’s worthwhile getting tested for sleep apnea.

Sleep apnea is a huge underlying contributor to hypertension, and it’s not looked at enough. In one study63, people with high blood pressure were compared to people without high blood pressure. The researchers made sure that both groups had the same age, gender, and weight. But the big difference was this: of those with normal blood pressure, only 4% of them had sleep apnea. But of those with high blood pressure, 38% of them had sleep apnea.

This was in “normal” hypertension. But in one study of what’s called “resistant hypertension”, the difference is even more stark. First of all, what’s “resistant hypertension?” Resistant hypertension is defined as having blood pressure over 140/90, despite taking at least 3 medications for high blood pressure, at their maximal doses. In short: resistant hypertension is when medications aren’t lowering blood pressure. In people with this type of hypertension, as much as 83% of them have sleep apnea, according to a study64 on unrecognized sleep apnea.

So the first step would be to go to your doctor, and ask for the test (it’s called a “sleep study”). 

This is even if:

  • You don’t snore
  • You’re not sleepy during the day
  • You don’t wake up with a dry mouth

The typical treatment for sleep apnea is the use of a CPAP machine (continuous positive airway pressure). It allows you to sleep at night much more restfully. In a study65 on untreated hypertension and difficulty in breathing, when people with high blood pressure used a CPAP machine for 3 weeks, their blood pressure dropped by an average of 7.8/5.3 mmHg.

This is a worthwhile condition to treat, because its effects are so far- reaching. Sleep apnea is either a contributing factor or a root cause for:

  • High blood pressure 
  • Stroke
  • Heart attacks
  • Heart failure
  • Depression 
  • Migraines 
  • Diabetes

…and more.

So the message is simple: get tested. If you have sleep apnea, get treated.

The Basics of Sleep Hygiene

Now, what if you’ve been tested, and you don’t have sleep apnea? Are you off the hook? Not so fast. If you don’t take your sleep seriously, you should. Just think about it: if you’re supposed to spend about one third of your life asleep, that must mean that it’s pretty important. So treat it with the care that it deserves.

Here are the bare basics that you need to do to optimize your sleep:

  1. Bedtime regularity. Go to bed at the same time each day, including weekends. When you go to bed at different times, it messes up your circadian rhythms. Imagine going to bed at 10:30PM one day, and 12:30AM the next day. To your body, it’s the equivalent of going to bed in different time zones.
  2. Bluelight. In the entire spectrum of light, blue light is meant to wake you up. Great when it’s time to wake up, but not so good when it’s time to go to sleep. A study on blue light and Insomnia, has shown that when blue light is blocked in the hours before bed, people fall asleep faster, and sleep longer. There are a couple of ways to block blue light:
  3. Wear blue-light blocking glasses about an hour before bed.
  4. Modernsmartphonesandcomputershavebluelightsettingsbuiltin, so just figure out how to change the blue light settings on your phone and computer.
  5. Topiggybackonthepreviouspoint, you want complete darkness. As dark as possible. You shouldn’t see moonlight, streetlights, or anything else. The more light there is in the room, the less melatonin you make (the hormone you release during sleep).
  6. Temperature. Your room should be cool. Maybe 1-2degreesCelsius (about 2-4 degrees Fahrenheit) lower than your daytime temperature.
  7. Caffeine. If you can drink it, and fall asleep just fine, do whatever you want. But if you drink it and it keeps you awake, keep it far enough from bedtime.
  8. Don’t keep your cellphone in the bedroom with you. If you use it as an alarm clock, just get an old-school alarm clock.
  9. Haveyourlastmeal3-5hoursbeforebed.The larger the meal, the farther from bedtime it should be because large meals increase the time it takes to fall asleep.
  10. Use your bedroom only for sleep and sex. If you do your work from your bedroom, it starts to become associated with a time of focus, not relaxation. Everything that does not sleep and sex should be done in other rooms. Well… you can have sex in other rooms, too.

If you’re wondering “can you get too much sleep?”, the answer is “yes”, although not enough sleep is a far bigger problem, so much more research is devoted to that. Generally speaking, risk of high blood pressure does rise over about 8-9 hours. So if that’s you, that should also be looked into. Very often, excessive sleep (hypersomnia) is linked to depression and hypothyroidism.

Supplements for Sleep

If you’ve implemented all of the suggestions from earlier in this article, it should help about 60-80% of you sleep better. But what about the remaining 20- 40%? Don’t worry, I won’t leave you hanging. In this section, I’ll show you some supplements to help you sleep.

Magnesium

You might be thinking “but Igor, I already use magnesium, and I’m still having a hard time sleeping.” Well, my friend, there may be 2 issues at hand: form and dosage.

If you’ll walk into a health food store, you’ll notice several different types of magnesium: magnesium oxide, magnesium chloride, magnesium citrate, and a few others.

Different forms of magnesium work on different tissues… and some don’t work all that well at all. Like magnesium oxide doesn’t get absorbed very well.

Magnesium citrate affects your digestive system. Magnesium taurate affects your cardiovascular system. But magnesium glycinate affects your nervous and muscular systems, so that’s the most effective form to help you sleep.

The second issue is dosage.

Different people have different requirements for magnesium. If you’re living a fairly stress-free life, eat lots of vegetables, and don’t exercise very hard, your requirements for supplemental magnesium are pretty low or nonexistent. If, on the other hand, you’re under a lot of stress, and exercise pretty hard, your requirements for magnesium rise (oh, and if you have high blood pressure, your requirements for magnesium are probably higher than for someone without high blood pressure).

So I recommend starting at 300 mg per day, taken after 4 PM in divided doses. If you end up sleeping well at that dose, stick with it. If you still don’t sleep well after about a week, increase the dose to 400 mg per day, after 4 PM in divided doses. Keep going up like that until you’ve either started to sleep well, or you’ve reached the maximal dose (see the supplement module for what the maximal dose is… it’s a bit more complex than an actual number).

How Does it Work?

Magnesium works because it relaxes different tissues of the body. In this case, we’re trying to relax the muscles and nervous system.

Magnesium and calcium are opposite minerals. Calcium helps with contraction and tension. Magnesium helps with relaxation. When there is an imbalance between calcium and magnesium in favour of calcium, you start having a hard time sleeping. But when the two are in balance, you’re in good health.

5-HTP

5-HTP is my second most frequently recommended supplement. I start my clients off at 300-500 mg and use the same process as with magnesium to figure out the correct dosage.

The way it works is by being a precursor to melatonin, the hormone you release when you’re asleep. Both 5-HTP and melatonin can be found in the popular dietary supplement Resurge that claims to improve sleep quality. It contains 100 mg of 5-HTP and 10 mg of melatonin. 

5-HTP gets converted to serotonin (AKA “the happy chemical”), which eventually gets converted to melatonin. Therefore it’s giving you the raw material necessary to make melatonin.

Melatonin

Lastly, the most common sleep supplement, melatonin. Why is it listed last here? Because it’s pretty misunderstood. At my seminars, a lot of people complain to me “I take/took melatonin, but it’s not helping me sleep.”

Again, there are a couple issues at hand: form and dosage.

As a general rule, good supplements do not come from drug stores, grocery stores and supermarkets. So if you bought your melatonin there, it explains why it’s not working for you.

The best melatonin is the kind you drop under the tongue.

In terms of dosage, I start my clients at 500 micrograms, and work them up either to 5 mg, or a dose that works, whichever comes first.

Furthermore, you have to use the right tool for the job. Melatonin’s primary function is in helping you fall asleep. It seems to be less effective in helping you stay asleep.

There you have it: our 3 most powerful supplements that we use to help people fall asleep.

You might be asking yourself though “do I need all 3?” The answer is that no single strategy works for 100% of the people, 100% of the time. For the cases when one supplement doesn’t work, use a different one.

And again, I want to reiterate what I mentioned at the beginning: supplementation is my second choice in helping people fall and stay asleep.

My first choice is improving sleep hygiene.

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