A new study finds that adults who experience daytime sleepiness and take 30 minutes or longer to fall asleep face significantly higher odds of both prevalent and incident hypertension.

Key takeaways:

• Individuals reporting excessive daytime sleepiness combined with an objective sleep-onset latency of 30 minutes or more on polysomnography had more than triple the odds of incident hypertension.
• The study followed 786 participants without hypertension for an average of 7.5 years, utilizing eight-hour sleep assessments to measure objective sleep disturbances.
• Researchers suggest that clinical evaluations for daytime sleepiness should extend beyond sleep apnea screening to include nighttime sleep difficulties and objective sleep measures.

A new study from Penn State College of Medicine indicates that excessive daytime sleepiness is associated with higher odds of both prevalent and incident hypertension, and taking 30 minutes or longer to fall asleep further increases that risk.

Results, presented at SLEEP 2026, show that individuals reporting excessive daytime sleepiness had 52% higher odds of prevalent hypertension and 74% higher odds of incident hypertension compared with normal controls. When excessive daytime sleepiness was combined with objectively prolonged sleep-onset latency of 30 minutes or more on polysomnography, the odds of prevalent hypertension more than doubled, and the odds of incident hypertension more than tripled.

“Adults with excessive daytime sleepiness and prolonged sleep-onset latency appeared to represent a distinct subgroup with significantly greater cardiovascular risk,” says lead author Alexandros Vgontzas, MD, professor of psychiatry and director of the Sleep Research and Treatment Center at Penn State College of Medicine, in a release. “Neither excessive daytime sleepiness on its own, nor prolonged sleep latency on its own, showed the same increased risk of hypertension.”

The study drew from 1,741 adults in the Penn State Adult Cohort at baseline. Incident hypertension analyses included 786 participants without hypertension at baseline who were followed for an average of 7.5 years. All participants underwent an eight-hour sleep assessment using polysomnography.

Excessive daytime sleepiness was defined by self-reported moderate-to-severe daytime sleepiness or irresistible sleep attacks. Prolonged sleep-onset latency of 30 minutes or more served as an objective index of sleep disturbance and hyperarousal. Hypertension was defined by blood pressure thresholds or antihypertensive treatment. Results were adjusted for sex, age, body mass index, race/ethnicity, smoking, caffeine use, alcohol use, diabetes, depression, sleep apnea severity, total sleep time, and wake time after sleep onset.

Vgontzas notes that recognizing this combined phenotype may have implications for clinical diagnosis and treatment planning.

“These findings suggest that evaluating excessive daytime sleepiness should extend beyond screening for sleep apnea alone,” says Vgontzas, professor of psychiatry, in a release. “Assessing nighttime sleep difficulties and objective sleep measures such as prolonged sleep-onset latency may help identify patients with elevated cardiovascular risk and support more targeted treatment approaches.”

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