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Work stress, poor sleep and high blood pressure – a lethal combination

Work stress, poor sleep and high blood pressure – a lethal combination

Work stress and poor sleep combined with high blood pressure are a lethal combination.

Once your blood pressure is higher than normal, the effects of a stressful work environment and impaired sleep are magnified.

The combination of the three factors increased threefold the likelihood of death from heart disease.

Doctors treating patients with highpertension should ask about stress and sleep patterns and employers should provide stress management and sleep treatment in the workplace, the authors of a study suggest.

Higher risks

The study at the German Research for Environmental Health at the Technical University of Munich found that work stress alone with high blood pressure increased the risk by 1.6 times and poor sleep alone with high blood pressure increased the risk 1.8 times.

Prof. Karl-Heinz Ladwig said work stress for the purposes of the study was defined as a job with high demand and low control – for example when an employer wants results but does not allow the worker the authority to make decisions.

“If you have high demands but also high control, in other words you can make decisions, this may even be positive for health,” said Prof. Ladwig. “But being entrapped in a pressured situation that you have no power to change is harmful.”

Impaired sleep was defined as having difficulty falling asleep and staying asleep.

“Maintaining sleep is the most common problem in people with stressful jobs,”he said.

Insidious problems

“These are insidious problems. The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave.”

He described the findings as a red flag for doctors treating those with high blood pressure saying they should ask these patients about sleep and job strain.

Employers, he suggested, should provide stress management and sleep treatment in the workplace.


His recommendations for stress management were:

  • Start with 5 to 10 minutes of relaxation.
  • Education about healthy lifestyle.
  • Help with smoking cessation, physical exercise, weight loss.
  • Techniques to cope with stress and anxiety at home and work.
  • How to monitor progress with stress management.
  • Improving social relationships and social support.


His suggestions for sleep improvement could include:

  • Stimulus control therapy: training to associate the bed/bedroom with sleep and set a consistent sleep-wake schedule.
  • Relaxation training: progressive muscle relaxation, and reducing intrusive thoughts at bedtime that interfere with sleep.
  • Sleep restriction therapy: curtailing the period in bed to the time spent asleep, thereby inducing mild sleep deprivation, then lengthening sleep time.
  • Paradoxical intention therapy: remaining passively awake and avoiding any effort (i.e. intention) to fall asleep, thereby eliminating anxiety.


The study  is published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology.

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