Effects of sleep and insomnia on cardiovascular disease - literature review
DOI:
https://doi.org/10.12775/QS.2024.17.53050Keywords
insomnia, Obstructive sleep apnea, hypertension, coronary heart disease, polysomnographyAbstract
Introduction:
Sleep disorders, including insomnia, obstructive sleep apnea (OSA) and other sleep disorders, are increasingly recognized as important risk factors for cardiovascular diseases such as hypertension and coronary artery disease. This review aims to analyze the current literature on the impact of sleep disorders on cardiovascular health, focusing on the underlying pathophysiological mechanisms and the effectiveness of diagnostic and therapeutic approaches. The results highlight the importance of early diagnosis and treatment of sleep disorders to reduce cardiovascular risk.
Aim of the Study:
The main objective of this study is to review and summarize recent findings on the relationship between sleep disorders and cardiovascular diseases, with a particular focus on hypertension and coronary artery disease. This study aims to elucidate the pathophysiological mechanisms linking these conditions and to evaluate the effectiveness of current diagnostic and therapeutic strategies.
Materials and Methods:
This review was conducted by searching PubMed for articles published in the last ten years (2014-2024) using keywords such as „insomnia”, „obstructive sleep apnea”, „hypertension”, „coronary heart disease”, „polysomnography”.
Conclusions:
The evidence reviewed in this article suggests that sleep disorders are important and independent risk factors for cardiovascular disease. Insomnia, obstructive sleep apnea and other sleep disorders contribute to cardiovascular morbidity through mechanisms such as increased sympathetic activity, systemic inflammation and metabolic dysregulation. Effective diagnosis and treatment of sleep disorders, including the use of CPAP therapy for obstructive sleep apnea and cognitive-behavioral therapy for insomnia, can mitigate these risks and improve cardiovascular outcomes.
References
M. M. Ohayon, “Epidemiology of insomnia: what we know and what we still need to learn.,” Sleep Med. Rev., vol. 6, no. 2, pp. 97–111, Apr. 2002,
https://doi.org/10.1053/smrv.2002.0186
F. Sofi, F. Cesari, A. Casini, C. Macchi, R. Abbate, and G. F. Gensini, “Insomnia and risk of cardiovascular disease: a meta-analysis.,” Eur. J. Prev. Cardiol., vol. 21, no. 1, pp. 57–64, Jan. 2014,
https://doi.org/10.1177/2047487312460020
P. E. Peppard, T. Young, J. H. Barnet, M. Palta, E. W. Hagen, and K. M. Hla, “Increased prevalence of sleep-disordered breathing in adults.,” Am. J. Epidemiol., vol. 177, no. 9, pp. 1006–1014, May 2013,
https://doi.org/10.1093/aje/kws342
J. M. Marin et al., “Association between treated and untreated obstructive sleep apnea and risk of hypertension.,” JAMA, vol. 307, no. 20, pp. 2169–2176, May 2012,
https://doi.org/10.1001/jama.2012.3418
R. P. Allen et al., “Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.,” Sleep Med., vol. 15, no. 8, pp. 860–873, Aug. 2014,
https://doi.org/10.1016/j.sleep.2014.03.025
W. D. P. Gusmão, I. R. O. M. Pureza, and C. R. C. Moreno, “Shift Work and Early Arterial Stiffness: A Systematic Review.,” Int. J. Environ. Res. Public Health, vol. 19, no. 21, Nov. 2022,
https://doi.org/10.3390/ijerph192114569
C. Vetter, E. E. Devore, C. A. Ramin, F. E. Speizer, W. C. Willett, and E. S. Schernhammer, “Mismatch of Sleep and Work Timing and Risk of Type 2 Diabetes.,” Diabetes Care, vol. 38, no. 9, pp. 1707–1713, Sep. 2015,
https://doi.org/10.2337/dc15-0302
K. Spiegelhalder, C. Scholtes, and D. Riemann, “The association between insomnia and cardiovascular diseases.,” Nat. Sci. Sleep, vol. 2, pp. 71–78, 2010,
https://doi.org/10.2147/nss.s7471
P. Meerlo, A. Sgoifo, and D. Suchecki, “Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity.,” Sleep Med. Rev., vol. 12, no. 3, pp. 197–210, Jun. 2008,
https://doi.org/10.1016/j.smrv.2007.07.007
L. Lavie, “Oxidative stress in obstructive sleep apnea and intermittent hypoxia--revisited--the bad ugly and good: implications to the heart and brain.,” Sleep Med. Rev., vol. 20, pp. 27–45, Apr. 2015,
https://doi.org/10.1016/j.smrv.2014.07.003
P. Lévy et al., “Obstructive sleep apnoea syndrome.,” Nat. Rev. Dis. Prim., vol. 1, p. 15015, Jun. 2015,
https://doi.org/10.1038/nrdp.2015.15
V. K. Kapur et al., “Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline.,” J. Clin. sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med., vol. 13, no. 3, pp. 479–504, Mar. 2017,
https://doi.org/10.5664/jcsm.6506
R. Heinzer et al., “Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.,” Lancet. Respir. Med., vol. 3, no. 4, pp. 310–318, Apr. 2015, https://doi.org/10.1016/S2213-2600(15)00043-0
R. P. Allen et al., “Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children: an IRLSSG task force report,” Sleep Med., vol. 41, pp. 27–44, Jan. 2018,
https://doi.org/10.1016/J.SLEEP.2017.11.1126
M. R. Irwin, R. Olmstead, and J. E. Carroll, “Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation.,” Biol. Psychiatry, vol. 80, no. 1, pp. 40–52, Jul. 2016,
https://doi.org/10.1016/j.biopsych.2015.05.014
F. Sauvet et al., “Effect of acute sleep deprivation on vascular function in healthy subjects.,” J. Appl. Physiol., vol. 108, no. 1, pp. 68–75, Jan. 2010,
https://doi.org/10.1152/japplphysiol.00851.2009
M. Kohler and J. R. Stradling, “Mechanisms of vascular damage in obstructive sleep apnea.,” Nat. Rev. Cardiol., vol. 7, no. 12, pp. 677–685, Dec. 2010,
https://doi.org/10.1038/nrcardio.2010.145
K. Spiegel, R. Leproult, and E. Van Cauter, “Impact of sleep debt on metabolic and endocrine function.,” Lancet (London, England), vol. 354, no. 9188, pp. 1435–1439, Oct. 1999,
https://doi.org/10.1016/S0140-6736(99)01376-8
D. Tsiptsios et al., “Association between sleep insufficiency and dyslipidemia: a cross-sectional study among Greek adults in the primary care setting.,” Sleep Sci. (Sao Paulo, Brazil), vol. 15, no. Spec 1, pp. 49–58, 2022,
https://doi.org/10.5935/1984-0063.20200124
F. De Torres-Alba, D. Gemma, E. Armada-Romero, J. R. Rey-Blas, E. López-de-Sá, and J. L. López-Sendon, “Obstructive sleep apnea and coronary artery disease: from pathophysiology to clinical implications.,” Pulm. Med., vol. 2013, p. 768064, 2013, https://doi.org/10.1155/2013/768064
M. A. Miller and N. E. Howarth, “Sleep and cardiovascular disease.,” Emerg. Top. life Sci., vol. 7, no. 5, pp. 457–466, Dec. 2023,
https://doi.org/10.1042/ETLS20230111
L. E. Laugsand, L. B. Strand, C. Platou, L. J. Vatten, and I. Janszky, “Insomnia and the risk of incident heart failure: a population study.,” Eur. Heart J., vol. 35, no. 21, pp. 1382–1393, Jun. 2014,
https://doi.org/10.1093/eurheartj/eht019
T. Chandola et al., “Work stress and coronary heart disease: what are the mechanisms?,” Eur. Heart J., vol. 29, no. 5, pp. 640–648, Mar. 2008,
https://doi.org/10.1093/eurheartj/ehm584
R. P. Pedrosa et al., “Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.,” Hypertens. (Dallas, Tex. 1979), vol. 58, no. 5, pp. 811–817, Nov. 2011,
https://doi.org/10.1161/HYPERTENSIONAHA.111.179788
T. Mooe, K. A. Franklin, K. Holmström, T. Rabben, and U. Wiklund, “Sleep-disordered breathing and coronary artery disease: long-term prognosis.,” Am. J. Respir. Crit. Care Med., vol. 164, no. 10 Pt 1, pp. 1910–1913, Nov. 2001,
https://doi.org/10.1164/ajrccm.164.10.2101072
J. M. Marin, S. J. Carrizo, E. Vicente, and A. G. N. Agusti, “Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study.,” Lancet (London, England), vol. 365, no. 9464, pp. 1046–1053, Mar. 2005,
https://doi.org/10.1016/S0140-6736(05)71141-7
D. J. Gottlieb, V. K. Somers, N. M. Punjabi, and J. W. Winkelman, “Restless legs syndrome and cardiovascular disease: a research roadmap.,” Sleep Med., vol. 31, pp. 10–17, Mar. 2017,
https://doi.org/10.1016/j.sleep.2016.08.008
C. Vetter, “Circadian disruption: What do we actually mean?,” Eur. J. Neurosci., vol. 51, no. 1, pp. 531–550, Jan. 2020,
https://doi.org/10.1111/ejn.14255
M. V Vyas et al., “Shift work and vascular events: systematic review and meta-analysis.,” BMJ, vol. 345, p. e4800, Jul. 2012,
https://doi.org/10.1136/bmj.e4800
E. Haus and M. H. Smolensky, “Biologic rhythms in the immune system.,” Chronobiol. Int., vol. 16, no. 5, pp. 581–622, Sep. 1999,
https://doi.org/10.3109/07420529908998730
J. M. Trauer, M. Y. Qian, J. S. Doyle, S. M. W. Rajaratnam, and D. Cunnington, “Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis.,” Ann. Intern. Med., vol. 163, no. 3, pp. 191–204, Aug. 2015,
https://doi.org/10.7326/M14-2841
I. H. Iftikhar et al., “Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis.,” J. Hypertens., vol. 32, no. 12, pp. 2341–50; discussion 2350, Dec. 2014,
https://doi.org/10.1097/HJH.0000000000000372
T. E. Weaver and R. R. Grunstein, “Adherence to continuous positive airway pressure therapy: the challenge to effective treatment.,” Proc. Am. Thorac. Soc., vol. 5, no. 2, pp. 173–178, Feb. 2008,
https://doi.org/10.1513/pats.200708-119MG
S. M. Caples et al., “Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis.,” Sleep, vol. 33, no. 10, pp. 1396–1407, Oct. 2010,
https://doi.org/10.1093/sleep/33.10.1396
P. J. J. Strollo et al., “Upper-airway stimulation for obstructive sleep apnea.,” N. Engl. J. Med., vol. 370, no. 2, pp. 139–149, Jan. 2014,
https://doi.org/10.1056/NEJMoa1308659
J. Arendt, “Melatonin and the pineal gland: influence on mammalian seasonal and circadian physiology.,” Rev. Reprod., vol. 3, no. 1, pp. 13–22, Jan. 1998,
https://doi.org/10.1530/ror.0.0030013
C. A. Espie et al., “Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer.,” J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol., vol. 26, no. 28, pp. 4651–4658, Oct. 2008,
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julita Gmitrzuk, Maciej Karasiński, Zuzanna Malinka, Katarzyna Wiśniewska, Anna Jachymek, Martyna Opatowska, Joanna Jakubiec, Tomasz Kucharski
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 195
Number of citations: 0
