Adults who report excessive daytime sleepiness have 52 percent higher odds of already having high blood pressure and 74 percent higher odds of developing it over time, according to a Penn State College of Medicine study presented at the SLEEP 2026 annual meeting in Baltimore. The finding, drawn from 1,741 adults in the Penn State Adult Cohort, points to a warning sign most people write off as ordinary tiredness.
The risk climbed sharply when daytime sleepiness was paired with a restless night. Participants who also took 30 minutes or longer to fall asleep, measured objectively during an eight-hour overnight sleep study, saw their odds of prevalent hypertension more than double and their odds of developing new hypertension more than triple. Neither sleepiness alone nor slow sleep onset alone produced that combined effect, the study reported.
What counts as excessive daytime sleepiness
Excessive daytime sleepiness is more than the mid-afternoon slump. Clinicians define it as trouble staying awake during normal daily activities, and it is often described by patients as moderate-to-severe drowsiness or sudden, hard-to-resist urges to fall asleep. It affects an estimated 10 to 20 percent of adults in the general population, and the causes range from insufficient sleep and shift work to sleep apnea, narcolepsy and other disorders of arousal.
The Penn State team followed 786 participants who were free of hypertension at baseline for an average of 7.5 years to track who developed the condition. The odds ratios held after adjustments for age, sex, body mass index, race and ethnicity, smoking, caffeine and alcohol use, diabetes, depression, sleep apnea severity, total sleep time and time spent awake after falling asleep, the researchers reported.
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A distinct sleep phenotype tied to cardiovascular risk
The combination of daytime sleepiness and a long time to fall asleep appears to mark a specific biological pattern the researchers call hyperarousal, a state in which the nervous system remains switched on when it should be winding down. That mismatch between tired days and wired nights may be what drives the blood pressure signal.
"Adults with excessive daytime sleepiness and prolonged sleep-onset latency appeared to represent a distinct subgroup with significantly greater cardiovascular risk," said Dr. Alexandros Vgontzas, professor of psychiatry and director of the Sleep Research and Treatment Center at Penn State College of Medicine, in comments accompanying the study.
Vgontzas said the results argue for a broader clinical assessment when patients complain of daytime sleepiness. Screening for sleep apnea alone may miss the pattern the Penn State team identified, and objective measures of nighttime sleep, including how long it takes to fall asleep, could help doctors flag people at higher cardiovascular risk earlier.
When to talk to a doctor
The findings are associations, not proof that daytime sleepiness raises blood pressure directly, and they come from a single cohort study presented at a scientific meeting. Even so, persistent daytime drowsiness that interferes with driving, work or daily activities, particularly when combined with trouble falling asleep at night, is a signal worth raising with a primary care physician or a sleep specialist. A clinical sleep evaluation can distinguish between sleep apnea, insomnia with hyperarousal and other treatable causes.
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The Penn State research was published as an abstract in the journal SLEEP, Volume 49, Supplement 1, on May 8, 2026, and presented at the SLEEP 2026 annual meeting on June 17, 2026.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.