Your pills might not be effective for a full 24 hours.
For reasons that aren't entirely clear, some people will have better blood pressure control all day if they take their pills before bed rather than in the morning.
You might have high blood pressure in the morning for reasons beside your medicine.
Sleep apnea is another cause of high blood pressure early in the morning.
Q: I have high blood pressure. I'm taking pills to reduce the pressure and they keep it pretty well under control during the day. However, I wake up in the morning with much higher pressure. Is this normal? Is there anything I can do to lower my early morning blood pressure?
A: Blood pressure normally comes down during sleep. It then returns to your usual level just before you wake up.
Many people with high blood pressure have this pattern of good control during the day, but high readings in the morning. Here are some reasons why this may happen:
1. Your pills might not be effective for a full 24 hours. You might need to split your pills in half. Take half of your dose in the morning. Take the other half at night. Of course, check with your doctor first.
2. For reasons that aren't entirely clear, some people will have better blood pressure control all day if they take their pills before bed rather than in the morning. So talk with your doctor about switching all of your pills to a nighttime dose.
3. You might have high blood pressure in the morning for reasons beside your medicine. Overuse of alcohol can raise blood pressure. So if you do drink alcohol, keep it to no more than a couple of drinks per day. One drink means 12 ounces of beer, 8 ounces of wine, or one shot of hard liquor.
4. Sleep apnea is another cause of high blood pressure early in the morning. With sleep apnea, the airway becomes blocked or breathing muscles stop moving. Breathing temporarily stops or becomes shallower. This can happen hundreds of times each night. Sleep apnea puts stress on the body. This raises adrenaline levels and blood pressure goes up. The most common symptoms of sleep apnea are loud snoring, poor sleep quality and excessive sleepiness during the day. Some people have morning headaches.
Talk with your doctor about these potential reasons for high morning blood pressures. Most likely some adjustment in your medications will get your readings under control. Also, maintaining a healthy weight, eating more plant-based foods, and exercising regularly help lower blood pressure all times of the day.
(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)