May 26 2026
High Blood Pressure Doesn’t Sleep — What You Should Know

May is National High Blood Pressure Education Month (often called Hypertension Awareness Month), and for people living with Narcolepsy, it is also a timely reminder to pay attention to an often-overlooked topic: your heart. A growing body of research shows that Narcolepsy and cardiovascular health —  especially blood pressure — are more closely tied than most people realize. 

The Narcolepsy and Heart Health Connection

The link between Narcolepsy and heart disease has drawn more attention in recent years. Studies suggest that people with Narcolepsy may have an increased prevalence of cardiovascular and cardiometabolic comorbidities — the simultaneous presence of two or more chronic diseases or conditions — and may be at greater risk for future cardiovascular events. One of the clearest findings comes from a study published in the Journal of the American Heart Association led by Dr. Younghoon Kwon, MD, MS, FACC, an associate professor in the Division of Cardiology at the University of Washington in Seattle. He found in an analysis of more than 9,300 adults with Narcolepsy that comorbid hypertension was present in 44% of people with Narcolepsy compared to only 31% of people without Narcolepsy. This finding demonstrates that people with Narcolepsy are significantly more likely to have hypertension than the general population. Hypertension, known as high blood pressure, is one of the most common and most preventable drivers of heart disease, stroke and kidney failure.

As Dr. Kwon shares, “In addition to Narcolepsy itself, its management, types of medication, lifestyle behaviors, and sodium intake can all synergistically impact cardiovascular health. These discussions are part of the long-term conversation we have with patients during follow-up appointments — introducing smoking cessation, weight management and physical activity, all of which can meaningfully reduce cardiovascular risk over time.” 

Another study published in SLEEP found that individuals with Narcolepsy were nearly twice as likely to develop cardiovascular disease and experience a major cardiac event — such as a heart attack or stroke — compared to people without Narcolepsy.

Why might this be? Part of the answer lies in the biology of Narcolepsy itself. Narcolepsy type 1 is a lifelong disorder of sleep-wake dysregulation. In addition to its role in sleep, orexin is a neuropeptide that helps stabilize transitions between sleep and wake and serves as a key regulator of wakefulness, arousal and appetite. Orexin also plays a role in regulating heart rate and blood pressure. Most people experience a natural dip in blood pressure at night during sleep, which is a healthy pattern that gives the heart a chance to rest. But this doesn’t always happen in people with Narcolepsy because disrupted nighttime sleep and excessive daytime sleepiness may interfere with that normal pattern.

What Happens When Hypertension Goes Unmanaged

High blood pressure is sometimes called “the silent killer” because people with high blood pressure may not feel symptoms, and the only way to know is to get your blood pressure checked. According to the CDC, nearly half of U.S. adults have high blood pressure, and only about 1 in 4 adults with high blood pressure has it under control. Those numbers should concern everyone, but they matter even more if you already face a higher cardiovascular risk because of Narcolepsy.

Over time, the constant extra force on artery walls from uncontrolled hypertension damages blood vessels and the heart. If it isn’t treated, it can cause other health conditions such as cognitive decline and kidney disease. Given that Narcolepsy usually develops in adolescents and young adults, who will be exposed to the adverse effects of the disease for decades, monitoring blood pressure early and often is one of the most practical steps you can take to protect your long-term health.

But here’s what matters: awareness is power and knowledge changes outcomes. And one of the most important things you can do for your heart is take a closer look at sodium including where it comes from, how much is too much and the sources you might not even be thinking about.

Sodium’s Role in Blood Pressure 

Sodium is an essential mineral that your body needs. However, most Americans consume far too much of it and for people with Narcolepsy, who already carry elevated cardiovascular risk, sodium intake is worth paying close attention to.

When you consume too much sodium, your body holds onto extra water to dilute it. That extra fluid increases the volume of blood flowing through your vessels, which pushes harder against artery walls. Over time, your heart works too hard from the added pressure, and the high force of the blood flow can damage your arteries and organs, including your heart, blood vessels, kidneys, brain and eyes.

So how much is too much? The most recent guidelines from the American College of Cardiology and the American Heart Association recommend no more than 2,300 mg per day and as low as 1,500 mg per day for people with hypertension. The World Health Organization suggests an even lower limit of 2,000 mg of sodium a day. To put that in perspective: one teaspoon of table salt contains about 2,300 mg of sodium. Most Americans routinely exceed that amount before dinner.

Where is Sodium Hiding? More Places Than You Think

People in the U.S. consume more than 70 percent of the daily recommendation of sodium, according to the FDA, and the majority comes from processed, packaged and prepared foods, not from table salt added to food when cooking or eating at home. This includes canned soups and beans, deli meats, frozen meals, pizza and fast food. Some foods, such as cereals and pastries, don’t taste salty but are high in sodium. Bread and dairy, such as cheese or cottage cheese, are foods with moderate amounts of sodium but can be major sources of sodium because they’re eaten so frequently. Condiments, such as salad dressings and teriyaki, are also surprisingly high. One tablespoon of soy sauce, for example, has about 1,000 mg of sodium. Even a single restaurant entrée may contain enough sodium to reach or go above your daily limit. That is why it is so important to read nutrition labels.

Medications and Sodium: An Important Conversation

And then there are medications. If you take prescription drugs, ask your health care team or pharmacist if the medication is high in sodium. This matters for people with Narcolepsy because some medications used to treat Narcolepsy symptoms contain significant amounts of sodium. Certain oxybate-based treatments, for instance, have different levels of sodium and understanding how those levels play into other personal hypertension risk factors is important. Every patient is different. If you take medications with higher sodium content, a conversation with your doctor can help you understand whether the benefits outweigh the risks for your health needs.

Over-the-counter (OTC) medications that dissolve, fizz or disperse in water, such as cold remedies, dissolvable pain relievers or vitamin pills can contain large quantities of hidden sodium. Sodium bicarbonate antacids contain a lot of sodium and are generally not recommended for people on sodium-restricted diets or those with high blood pressure. 

While Narcolepsy is a life-long condition, it can be treated with medicine, such as drugs that stimulate the central nervous system, drugs that suppress REM sleep, certain antidepressants and others. Some of these medications are life-changing; however, it’s important to note that treatment decisions for people with Narcolepsy are deeply personal and every person with Narcolepsy deserves individualized and tailored access to the therapy that best fits their unique needs and symptoms. If you are taking any medication that contains sodium — whether for Narcolepsy or anything else — speak with your full care team (physician and cardiologist) so they can factor it into your overall health picture. Together, you can make informed choices about diet, health monitoring and treatment that balance your sleep health with your heart health. After all, it’s about managing the disorder with your lifestyle.

Practical Steps to Take Control

The good news is that managing blood pressure is possible. Small changes can make a real difference. Start by knowing your numbers: ask your doctor to check your blood pressure at every visit. You can also purchase a validated home blood pressure monitor and track your readings at home. A normal reading is below 120/80 mmHg. 

Some other practical steps include:

• Read labels. Aim for foods with less than 140 mg of sodium per serving. Look for “low sodium” or “no salt added” options. As a general guide, 5% DV (Daily Value) or less of sodium per serving is considered low, and 20% DV or more of sodium per serving is considered high. 
• Cook more at home. Cook more meals at home with fresh fruits, vegetables and lean proteins. Use herbs, citrus and spices instead of salt to add flavor. When you do eat out, ask for sauces on the side and choose smaller portions.
• Check your medications. Ask your pharmacist about the sodium content of any prescription or OTC medications you take regularly.
• Talk to your doctor. Share your full medication list — including supplements and OTC products — and ask for cardiovascular monitoring as part of your ongoing Narcolepsy care.
• Connect with community. WomenHeart, the first and only national patient-centered organization in the United States solely dedicated to supporting women living with or at risk of heart disease, has a support network that provides peer-led resources specifically for women navigating heart disease.  Wake Up Narcolepsy also offers a weekly online support group that addresses Narcolepsy and comorbidities including heart health. 

The Bigger Picture

For people with Narcolepsy, getting the rest your body needs and protecting the health of your heart are deeply and biologically intertwined.

According to Dr. Virend K. Somers, one of the country’s leading experts at the intersection of sleep medicine and cardiovascular health and a consultant cardiologist in the Department of Cardiovascular Diseases at the Mayo Clinic, “The cardiovascular implications of Narcolepsy are well-documented. At least a third of people with Narcolepsy don’t have a drop in blood pressure while sleeping, which means there is an increased “blood pressure burden” on the heart and the blood vessels. Elevated rates of hypertension, heart failure and stroke in this population underscore the urgency of integrating cardiovascular risk assessment into routine Narcolepsy management. Clinicians and patients alike should treat blood pressure control as a priority.” 

Take stock of your cardiovascular health as it is one of the most powerful things you can do for your overall well-being, especially if you have Narcolepsy. Your heart will thank you.

This blog is part of the Hearts & Rest campaign by Wake Up Narcolepsy in partnership with WomenHeart.org. Their essential guide, The Impact of Sleep on Heart Health, is a must-read resource on the overlap between sleep health and heart health. Their website also has additional educational materials and practical tools on how to help you or someone you love stay heart-healthy.

This blog post is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your lifestyle, medication or treatment plan.