Insomnia and Risk of Cardiovascular Disease.
Insomnia is the most prevalent sleep disorder in the United States and has high comorbidity with a number of cardiovascular diseases (CVDs). In the past decade, a number of observational studies have demonstrated an association between insomnia and incident cardiovascular disease (CVD) morbidity and mortality, including hypertension (HTN), coronary heart disease (CHD), and heart failure (HF). Despite some inconsistencies in the literature, likely due to variations in how insomnia is defined and measured, the existing data suggest that insomnia, especially when accompanied by short sleep duration, is associated with increased risk for HTN, CHD and recurrent acute coronary syndrome, and HF. Purported mechanisms likely relate to dysregulation of the hypothalamic-pituitary axis, increased sympathetic nervous system activity, and increased inflammation. This paper reviews the most recent studies of insomnia and CVD and the potential pathophysiological mechanisms underlying this relationship and highlights the need for randomized trials to further elucidate the nature of the relationship between insomnia and CVD.
Department of Medicine, Division of Sleep, Circadian Rhythm, and Neurobiology, Brigham and Women's Hospital, Boston, MA. Electronic address: sjavaheri@partners.org.
Sogol
S
Javaheri
Department of Medicine, Division of Sleep, Circadian Rhythm, and Neurobiology, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Division of Sleep, Beth Israel Deaconess Medical Center, Boston, MA.
Susan
S
Redline
D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000401:mortality; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000401:mortality; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D064887:Observational Studies as Topic; D010913:Pituitary-Adrenal System / Q000502:physiology; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000401:mortality
D002097:C-Reactive Protein
cardiovascular disease; insomnia; sleep medicine