Sleep Duration and Hypertension: Epidemiological Evidence and Underlying Mechanisms

Joshua M. Bock, Soumya Vungarala, Naima Covassin, Virend K. Somers

Research output: Contribution to journalReview articlepeer-review


While the contribution of several physiological systems to arterial blood pressure regulation has been studied extensively, the role of normal and disrupted sleep as a modifiable determinant of blood pressure control, and in the pathophysiology of hypertension, has only recently emerged. Several sleep disorders, including sleep apnea and insomnia, are thought to contribute to the development of hypertension, although less attention is paid to the relationship between sleep duration and blood pressure independent of sleep disorders per se. Accordingly, this review focuses principally on the physiology of sleep and the consequences of abnormal sleep duration both experimentally and at the population level. Clinical implications for patients with insomnia who may or may not have abbreviated sleep duration are explored. As a corollary, we further review studies of the effects of sleep extension on blood pressure regulation. We also discuss epidemiological evidence suggesting that long sleep may also be associated with hypertension and describe the parabolic relationship between total sleep time and blood pressure. We conclude by highlighting gaps in the literature regarding the potential role of gut microbial health in the cross-communication of lifestyle patterns (exercise, diet, and sleep) with blood pressure regulation. Additionally, we discuss populations at increased risk of short sleep, and specifically the need to understand mechanisms and therapeutic opportunities in women, pregnancy, the elderly, and in African Americans.

Original languageEnglish (US)
Pages (from-to)3-11
Number of pages9
JournalAmerican journal of hypertension
Issue number1
StatePublished - Jan 1 2022


  • blood pressure
  • hypertension
  • sleep

ASJC Scopus subject areas

  • Internal Medicine


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