Nocturnal hypotension
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Nocturnal hypotension is when a personтАЩs blood pressure falls too low during sleep. It is normal for blood pressure to drop somewhat at night, but in some people the fall is much larger than usual and can reduce blood flow to sensitive tissues. When blood flow drops, organs that need steady circulationтАФlike the optic nerve at the back of the eyeтАФmay receive less oxygen and nutrients. Causes include taking blood-pressure medicines at night, certain medical conditions that affect blood pressure regulation, or natural exaggerated dipping patterns. Often there are few or no symptoms, so the condition can go unnoticed without monitoring. This matters because significant nighttime drops in blood pressure have been linked to worsening of conditions where steady blood flow is important, especially in vulnerable eyes. Detecting it typically requires 24-hour ambulatory blood pressure monitoring so a clinician can see the night-time pattern. Treatment may involve changing medication timing, adjusting doses, managing underlying health issues, or other strategies to keep overnight blood pressure from falling too far. If someone is at risk, talking with a healthcare provider about testing and safe adjustments can help protect vision and overall health.