Hello! Welcome and thank you for asking on HCM! You should know that sleep apnea can cause difficulty breathing during the night with blood pressure spikes. Your husband s blood pressure values are really high and some tests need to be done to investigate for the possible underlying causes: - a chest X ray study - a resting ECG - thyroid hormone levels for thyroid dysfunction - complete blood count for anemia - blood electrolytes for electrolyte imbalance - blood gas analysis - fasting glucose for diabetes - kidney and liver function tests. If these tests result normal, a multi latency sleep test should be done to exclude possible sleep apnea. But, if no other underlying cause is found, I would recommend discussing with your doctor on the possibility of making some changes on his blood pressure therapy (raise the doses or add a new anti-hypertensive drug) in order to have a better control of his blood pressure values. Hope to have been helpful! Wishing all the best, Dr. Iliri