Please Please if anyone can help…
My name is Debra and I’m new to this group. I started C-pap therapy the first of March 2025 due to OSA and High blood pressure. My issue is that every night when i put my mask on and after falling asleep I awake every 2 hour’s with elevated Blood pressure. My reading will be like 220/112 then i take a medication called “Clonidine” to get my bp back down. I go back to sleep after getting it down. I awake 2 hour’s later with the same thing elevated Blood pressure. I take my blood pressure medication before bed. I know C-pap is supposed to lower your blood pressure but thats not happening with me. I have discussed this with my Cardiologist and Pulmonary Doctor’s and the Cardiologist just keeps changing my blood pressure medication which is not helping. My mask seal is good every night and there’s no leaks in my hose are anywhere. I wear a full face mask i sleep with my mouth opened. Does anyone have any suggestions to what could be causing me to have Nocturnal High blood pressure?? This is so scary and frustrating. Please, Please any suggestions would be greatly appreciated…
Does anyone here go through this?? It’s so crazy 
…Thanks in advance for your help!!! Debra
Hi Debra, welcome to the group,I am really sorry you are going through this. That sounds incredibly frustrating and scary especially when you are doing everything right with your CPAP and medications.
While I am not a doctor, here are a few things that might help you and your doctors narrow down the cause:
CPAP Pressure Settings : Sometimes, if the pressure is too high or too low, it can cause arousals and stress responses during sleep. You might want to ask your sleep specialist to review your pressure settings or consider a pressure titration study.
Sleep Study Data : If your machine supports data tracking, reviewing your AHI apnea-hypopnea index, leak rate and flow limitations can reveal if you are still having events that are causing blood pressure spikes.
Nocturnal Hypertension Workup : This could be due to underlying conditions like hyperaldosteronism, kidney issues or even anxiety-related spikes. A 24-hour ambulatory blood pressure monitor might help pinpoint patterns more accurately.
CPAP Mask Fit & Comfort : Even if the mask seal is technically good, discomfort or subtle leaks can disturb your sleep and elevate stress hormones. Trying a different mask style might be worth exploring.
Clonidine : Since you’re relying on it nightly, it might be worth discussing with your doctor whether the dosage or timing of your long acting BP meds needs to be adjusted to better cover the night.
You are absolutely not alone, some people take time to adjust to CPAP and nocturnal BP issues can be complex. Keep advocating for yourself and do not give up. You are doing the right thing by seeking answers.
Wishing you better nights ahead,
Best regards by gumalay56
Thank you so very much for your response. You were such a big help. I checked with my Pulmonary Doctor and he sent a signal to my C-pap machine to set it at a higher pressure. I’m Praying this helps with my Nocturnal high blood pressure. I see my Cardiologist this Friday the 18th and will discuss what you suggested concerning my Blood Pressure medication. Once again thank you so much. Thank you for caring and taking the time to respond!!! You may have just been a Lifesaver…God Bless!!!
#forevergrateful
#atruelifesaver
#mysinceregratitude
I cannot use the CPAP but also wake up every 1.5-2 hours, often with elevated blood pressure, heart racing. Sometimes I get up and sit still or meditate for 15 minutes to half hour, which usually lowers my pressure. My cardiologist has prescribed several blood pressure medications, two taken in the morning, two taken before bed. It took a while to adjust the dosages, but it works pretty well most of the time. Metoprolol and amlodipine in the morning with breakfast. Metroprolol with losartan before bed. Ask your doctor.