DARIEN, IL – A new study from Penn State College of Medicine to be presented at the SLEEP 2026 annual meeting found 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 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, odds of prevalent hypertension more than doubled, and 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," said lead author Dr. Alexandros Vgontzas, a professor of psychiatry and director of the Sleep Research and Treatment Center at Penn State College of Medicine in Hershey, Pennsylvania. "Neither excessive daytime sleepiness on its own, nor prolonged sleep latency on its own, showed the same increased risk of hypertension."
Sleepiness is a critical patient-reported outcome that is associated with increased risk for adverse health effects and diminished quality of life, according to an American Academy of Sleep Medicine position statement . Excessive sleepiness is defined as the inability to stay awake and alert during the major waking episodes of the day. The AASM recommends that adults prioritize healthy sleep as part of an overall approach to cardiovascular health.
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 noted 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," Vgontzas said. "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."
The research abstract was published recently in an online supplement of the journal Sleep and will be presented June 17 during SLEEP 2026 in Baltimore. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.
