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Why is My Blood Pressure Higher in the Morning?

Nina Ghamrawi, MS, RD, CDE
November 10, 2022
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An elevated morning blood pressure may not mean much at first, but when we monitor blood pressure regularly, you may start to notice a pattern. Blood pressure is typically at its lowest in the morning when you first wake up, and highest towards the afternoon or evening. But when your blood pressure in the morning is higher than during the rest of the day, this could put you at a higher risk, and may be a sign of another problem. If you often see higher blood pressure readings in the mornings, here’s the potential cause and what to do about it.

Blood pressure has a daily pattern. Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening. A rise in blood pressure overnight to early morning (or during the time that you are asleep) has been linked to an increased risk of heart disease.

What causes a blood pressure rise in the morning? It’s as simple as hormones!

While a high morning blood pressure is less common, there is a reasonable explanation for it. Circadian rhythm is a daily 24-hour activity cycle that affects our sleep/wake patterns. In the morning, the body releases certain hormones such as adrenaline and noradrenaline. These hormones give you energy boosts but can also raise your blood pressure. This morning increase in blood pressure is usually between 6 am and noon, and could be an indication of your sleep quality.

How do I improve my sleep quality?

To improve sleep quality, try these things: lengthen your bedtime routine, avoid large meals or heavy snacks before bed, reduce light and sound disturbances, and use inhalers, CPAP, or other breathing aides if needed.

Getting a good night's sleep is helpful in maintaining blood pressure. Though "restful" is different for everyone, being consistent about your sleep patterns helps. Aim for a similar sleep schedule to help with blood pressure maintenance.

How often should I monitor?

To catch all the peaks and valleys of blood pressure, it is best to monitor multiple times per day:

  • When you first wake up and after you use the restroom
  • AND also in the evening, a couple hours after dinner and relaxation, and also after emptying your bowels
  • ALSO check blood pressure in the mid-afternoon. If you've had a high stress or busy day, you should also take a moment to check your blood pressure.

If you don’t have the time or routine to check regularly, taking a baseline blood pressure measurement once per month is also a great way to keep tabs on your blood pressure trends. A baseline is measured using 6 pairs of readings, or 12 total readings, done ideally within a 1-week span. A blood pressure baseline reading pair is basically 2 readings taken 1 minute apart. Do this pair in the morning, and also in the evening, for 3 days.

Takeaways

If you often see higher blood pressure readings in the morning, the cause is likely related to poor sleep quality, but may be affected by other factors that affect circadian rhythm. If you are new to monitoring, want a tighter control, or recently had a change in lifestyle routine, or schedule for work or sleep, you should probably check blood pressure more often than once per day.

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