AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Nocturnal Blood Pressure Surges Across Sleep Disorders
By Chaudhari A, Khayat R, Rinehart J et al.
Introduction: Sleep disordered breathing is associated with poor cardiovascular outcomes. However, the mechanisms that drive this correlation are not well understood. Hemodynamics during sleep is especially difficult to monitor, as tools today lack the accuracy to track parameters such as blood pressure (BP). While ambulatory blood pressure monitoring (ABPM) has been around for a long time, its discomfort and disruption of sleep, along with its intermittent nature make it not a strong tool for identifying rapid BP changes. A novel, wearable sensor that captures beat-by-beat BP changes, has been validated against the arterial line. We sought to adapt this device to measure BP changes continuously during sleep. Methods: We developed a calibration-free technique that measures transient BP changes during sleep using the novel sensor and then compared its performance against an arterial line on patients undergoing surgery. After evaluating performance, we then applied the sensor on patients undergoing overnight polysomnography (PSG) and monitored BP during sleep events, such as apneas, to better understand the cardiovascular burden of each sleep event. Results: Across forty-one patients undergoing surgery, the mean absolute difference (MAD) was 4.84 mmHg, which falls well below the recommended acceptable error threshold specified by the IEEE 1708-2025 standard for wearable non-invasive blood pressure monitors (MAD < 7 mmHg) . In forty patients undergoing PSG, 70.90% of scored sleep events exhibited BP changes of more than 15 mmHg, indicating variance in cardiovascular response across sleep events, that is missed by current binary scoring practices. Conclusions: A calibration-free wearable sensor can accurately track beat-by-beat blood pressure changes during sleep, with validation performance meeting IEEE 1708 standards. Its low-profile design allows for comfortable wear throughout the night, making continuous BP monitoring during sleep feasible. This capability may offer a valuable tool for better understanding the cardiovascular etiology of sleep disordered breathing, and its integration with existing sleep disorder therapies could enable a feedback system for real-time hemodynamic monitoring and intervention. Figure 1. Sympathetic responses captured by the sensor signal during a series of sleep disordered breathing (SDB) events in a 10-minute period. The data is from a 70-year-old female diagnosed with obstructive sleep apnea. The top row reflects the physiological responses to these events captured in the detrended signal, with corresponding changes in the heart rate (calculated using sensor signal) shown in the bottom row. Physiological responses to each of the events are evident in the PSG-related signals: PPG signal (2nd row), respiratory signals (3rd row), and SpO ₂ signal (4th row).