Patients experiencing both excessive daytime sleepiness and prolonged sleep-onset latency face a significantly higher risk of hypertension.
RT’s Three Key Takeaways:
- Increased Hypertension Risk: Individuals with excessive daytime sleepiness have 52% higher odds of prevalent hypertension and 74% higher odds of incident hypertension compared to those with normal sleep patterns.
- Combined Effect: The risk of incident hypertension more than triples when excessive daytime sleepiness is paired with an objective sleep-onset latency of 30 minutes or more.
- Clinical Screening: Researchers suggested that healthcare providers should look beyond sleep apnea and evaluate nighttime sleep difficulties and objective sleep measures to identify patients with elevated cardiovascular risk.
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, according to data presented at Sleep 2026.
The study from Penn State College of Medicine found 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 sleepiness was combined with an objective 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,” said Alexandros Vgontzas, a professor of psychiatry and director of the Sleep Research and Treatment Center at Penn State College of Medicine, in a news release. “Neither excessive daytime sleepiness on its own, nor prolonged sleep latency on its own, showed the same increased risk of hypertension.”
The study analyzed 1,741 adults from the Penn State Adult Cohort. For the incident hypertension analysis, researchers followed 786 participants without hypertension at baseline 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. Results were adjusted for factors including age, body mass index, smoking, alcohol use, and sleep apnea severity.
The American Academy of Sleep Medicine (AASM) recommends that adults prioritize healthy sleep as part of an overall approach to cardiovascular health. 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,” said Vgontzas, a professor of psychiatry and director of the Sleep Research and Treatment Center at Penn State College of Medicine, in a news 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.”
