Sleep and Resistant Hypertension

  • Mercedes R. CarnethonEmail author
  • Dayna A. Johnson
Sleep and Hypertension (S Justin Thomas, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Sleep and Hypertension


Purpose of Review

The goal of the present review is to describe the current findings on the association of sleep with resistant hypertension (hypertension that remains uncontrolled despite the use of three or more antihypertensive medications from different classes, including a diuretic).

Recent Findings

Sleep disturbances, particularly obstructive sleep apnea (OSA), are highly prevalent among adults who have resistant hypertension. Randomized controlled trials indicate that treating OSA has modest effects on blood pressure lowering among those with the highest initial blood pressure. There is a paucity of research on the association of habitual sleep and other sleep disturbances with resistant hypertension. Of note, the most recent observational studies describing the association of OSA with resistant hypertension are comprised primarily of non-white race/ethnic groups who are far more likely to have resistant hypertension.


OSA is associated with resistant hypertension, but there is limited data on associations between sleep characteristics and resistant hypertension. Future studies should investigate whether treating OSA can reduce disparities in resistant hypertension and whether other aspects of sleep also contribute to resistant hypertension.


Sleep Obstructive sleep apnea Racial/ethnic disparities Hypertension 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA

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