Which of the following can cause hypotension during sedation?

During sedation, a prolonged NPO (nothing by mouth) period can lead to hypotension primarily because of dehydration and the associated reduction in blood volume. When a patient is NPO for an extended time, they do not intake fluids, which can result in decreased intravascular volume. This decrease can impede the heart's ability to maintain adequate blood pressure, especially when sedation is administered, as sedative agents can further reduce sympathetic tone and vascular resistance.

Inadequate fluid intake during the NPO period means that the patient may already be in a state of relative hypovolemia by the time sedation occurs, making them more susceptible to drops in blood pressure. This link between hydration status and hemodynamic stability highlights why it is crucial to assess a patient’s fluid balance prior to procedure-related sedation.

Other factors such as fluid overload might cause hypertension rather than hypotension, while high caffeine intake generally does not play a significant role in sedation-related blood pressure changes. Excessive sleep could result in temporary hypotension due to reduced heart rate, but it is not a direct or common cause related to the sedation process itself.