Elevated nighttime blood pressure is a well-established predictor of cardiovascular disease. While 24 hour ambulatory blood pressure monitoring (ABPM) from the upper arm is the standard for nocturnal blood pressure assessment, wrist-type home blood pressure monitoring (HBPM) offers potential advantages in convenience, yet its usability and impact on sleep quality remain underexplored.To compare the usability and impact on sleep quality of a wrist-type HBPM device and conventional upper-arm 24 hour ABPM device.In this randomized crossover study, 60 community-dwelling individuals (50-80 years) from the RED-LRGP trial underwent wrist-type HBPM (Omron HEM-9601T) and upper-arm ABPM. HBPM included three nocturnal readings per night (4 hours after bedtime, at 02:00, and 04:00 hour) for five nights, and morning and evening daytime readings on these same days. ABPM included single day-and-night measurements with cuff inflations every hour. Participants completed the System Usability Scale (SUS) and visual analogue scale (VAS) for sleep quality after each device. Linear mixed-effects models were used to compare usability (SUS) and sleep quality (VAS) between devices.Sixty participants (mean age 58 years, 57% female, 23% hypertensive) completed questionnaires. HBPM showed higher usability (SUS 71.9 vs. 52.4; p<0.0001) and better sleep quality (VAS 74.6 vs. 58.9; p<0.0001) than ABPM. Repeated nightly HBPM captured night-to-night variability, detecting nocturnal hypertension in 27% to 39% of participants versus 26% by single-night ABPM, and non-dippers in 7% to 14% versus 25% by ABPM. Sixteen participants without obesity, hypertension or other relevant comorbidities were classified as HBPM non-dippers on one or more nights.This study may be valuable for guiding clinical applications of wrist-type HBPM as a patient-friendly approach for characterizing nocturnal BP patterns.Wrist-type HBPM for five days and nights improves usability and preserves sleep quality compared with conventional, single day-and-night upper-arm ABPM. This furthermore enables repeated nocturnal measurements to capture night-to-night BP variability and supporting its use as a practical, user-friendly tool for home-based nocturnal BP monitoring.