First, there is a possibility that your 186/130 can be wrong, and caused by that the monitor is unable to sense any pulse waves. That may produce readings in that range. But let's assume it's not.
Blood pressure is supposed to increase and decrease through the day but what you describe (given that it's correct) sounds far too much. Do you have symptoms when your blood pressure is that high. Anxiety? Severe stress? Any known triggers?
What is your average blood pressure? What does your doctor think?
If you truly have a blood pressure in that range, it's usually caused by something. There is a rare condition known as pheocromocytoma where (usually benign) tumors may release lots of adrenaline and similar substances at random times through the day. The condition, however, is not benign because it's severely stressing the body. But if that was the case, you would usually feel intense anxiety during the events. To rule it out, your doctor must do some blood tests, metanephrine and normetanephrine, and possibly 24-hour urine collection to see how much adrenaline you produce daily.
These very low and very high numbers appeared regularly on two 24 hour BP monitors provided by my GP, a few months apart. Test for pheo was clear.
In addition, I have respiratory muscle weakness which is 50% below what it should be and since my last message, my consultants have decided this is caused by a neuromuscular disease. They are putting their money on congenital myasthenia (I have had extreme weakness, ptosis, scoliosis etc since childhood, and diaphragmatic weakness responds well to typical CMS meds). I am currently awaiting genetic testing.
I am not breathing well during sleep and my respiratory consultant has ordered an urgent sleep study as she predicts I am waking up many times during the night because of the decreased breathing.
If this were the case, and my diaphragmatic strength is even weaker when I am not awake, could it explain my very low blood pressure while sleeping?
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