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Exploring the Silent Connection Between Sleep Disorders (i.e., OSA, Insomnia) and Cardiovascular Diseases: Pathophysiology and Insights

Year 2025, Volume: 7 Issue: 1, 1 - 11, 29.01.2025
https://doi.org/10.46310/tjim.1491486

Abstract

Sleep is a complex physiological phenomenon crucial for health. Despite this, millions suffer from sleep disorders, contributing to a range of health issues, particularly cardiovascular diseases (CVD). The pathophysiological mechanisms linking sleep disorders, such as insomnia and obstructive sleep apnea (OSA), to cardiovascular risk factors include disruptions in inflammatory, autonomic, and metabolic pathways. Increased sympathetic nervous system activity, chronic inflammation, and metabolic dysregulation stemming from poor sleep can lead to conditions like hypertension, obesity, and insulin resistance, significantly elevating the risk for CVD. This article reviews the connection between sleep quality and cardiovascular disease risks. Sleep disorders (i.e., insomnia and OSA) have been found to impact cardiovascular risk factors adversely. Studies have found an association between abnormal sleep and increased cardiovascular morbidity and mortality by higher risks of hypertension, diabetes, obesity, and dyslipidemia. The review also discusses non-pharmacological interventions, such as relaxation training, Cognitive behavioral therapy for insomnia (CBT-I), and red-light therapy, which have shown efficacy in improving sleep quality and reducing cardiovascular risks. Dual orexin receptor antagonists and Ashwagandha promise to enhance sleep quality and cardiovascular health, but further research is needed. Addressing sleep disorders and promoting healthy sleep practices are essential for mitigating the global burden of cardiovascular diseases, underscoring the need for continued research and effective public health interventions.

References

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Year 2025, Volume: 7 Issue: 1, 1 - 11, 29.01.2025
https://doi.org/10.46310/tjim.1491486

Abstract

References

  • Jawabri KH, Raja A. Physiology, sleep patterns. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Available at: https://www.ncbi.nlm.nih.gov/books/NBK551680/.
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  • Hanson JA, Huecker MR. Sleep deprivation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jun 12. Available at: https://www.ncbi.nlm.nih.gov/books/NBK547676/.
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  • Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, Pandi-Perumal SR. The global problem of insufficient sleep and its serious public health implications. Healthcare (Basel). 2018 Dec 20;7(1):1. doi: 10.3390/healthcare7010001.
  • Lao XQ, Liu X, Deng HB, Chan TC, Ho KF, Wang F, Vermeulen R, Tam T, Wong MCS, Tse LA, Chang LY, Yeoh EK. Sleep quality, sleep duration, and the risk of coronary heart disease: A prospective cohort study with 60,586 adults. J Clin Sleep Med. 2018 Jan 15;14(1):109-17. doi: 10.5664/jcsm.6894.
  • Krittanawong C, Tunhasiriwet A, Wang Z, Zhang H, Farrell AM, Chirapongsathorn S, Sun T, Kitai T, Argulian E. Association between short and long sleep durations and cardiovascular outcomes: a systematic review and meta-analysis. Eur Heart J Acute Cardiovasc Care. 2019 Dec;8(8):762-70. doi: 10.1177/2048872617741733.
  • Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath. 2022 Sep;26(3):1479-501. doi: 10.1007/s11325-021-02458-1.
  • Tran V, De Silva TM, Sobey CG, Lim K, Drummond GR, Vinh A, Jelinic M. The vascular consequences of metabolic syndrome: rodent models, endothelial dysfunction, and current therapies. Front Pharmacol. 2020 Mar 4;11:148. doi: 10.3389/fphar.2020.00148.
  • Khan MS, Aouad R. The effects of insomnia and sleep loss on cardiovascular disease. Sleep Med Clin. 2017 Jun;12(2):167-77. doi: 10.1016/j.jsmc.2017.01.005.
  • Murck H, Schüssler P, Steiger A. Renin-angiotensin-aldosterone system: the forgotten stress hormone system: relationship to depression and sleep. Pharmacopsychiatry. 2012 May;45(3):83-95. doi: 10.1055/s-0031-1291346.
  • Seravalle G, Mancia G, Grassi G. Sympathetic nervous system, sleep, and hypertension. Curr Hypertens Rep. 2018 Jul 6;20(9):74. doi: 10.1007/s11906-018-0874-y.
  • Jarrin DC, Alvaro PK, Bouchard MA, Jarrin SD, Drake CL, Morin CM. Insomnia and hypertension: A systematic review. Sleep Med Rev. 2018 Oct;41:3-38. doi: 10.1016/j.smrv.2018.02.003.
  • About high blood pressure. Potential problems having high blood pressure could cause: Heart attack and heart disease. Centers for Disease Control and Prevention. May 15, 2024. Available at: https://www.cdc.gov/high-blood-pressure/about/index.html.
  • Willeit P, Thompson SG, Agewall S, Bergström G, Bickel H, Catapano AL, Chien KL, de Groot E, Empana JP, Etgen T, Franco OH, Iglseder B, Johnsen SH, Kavousi M, Lind L, Liu J, Mathiesen EB, Norata GD, Olsen MH, Papagianni A, Poppert H, Price JF, Sacco RL, Yanez DN, Zhao D, Schminke U, Bülbül A, Polak JF, Sitzer M, Hofman A, Grigore L, Dörr M, Su TC, Ducimetière P, Xie W, Ronkainen K, Kiechl S, Rundek T, Robertson C, Fagerberg B, Bokemark L, Steinmetz H, Ikram MA, Völzke H, Lin HJ, Plichart M, Tuomainen TP, Desvarieux M, McLachlan S, Schmidt C, Kauhanen J, Willeit J, Lorenz MW, Sander D; PROG-IMT study group. Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration. Eur J Prev Cardiol. 2016 Jan;23(2):194-205. doi: 10.1177/2047487314560664.
  • Irwin MR, Cole SW. Reciprocal regulation of the neural and innate immune systems. Nat Rev Immunol. 2011 Aug 5;11(9):625-32. doi: 10.1038/nri3042.
  • Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull. 2014 May;140(3):774-815. doi: 10.1037/a0035302.
  • Grandner MA, Sands-Lincoln MR, Pak VM, Garland SN. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nat Sci Sleep. 2013 Jul 22;5:93-107. doi: 10.2147/NSS.S31063.
  • Miller MA, Kruisbrink M, Wallace J, Ji C, Cappuccio FP. Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies. Sleep. 2018 Apr 1;41(4). doi: 10.1093/sleep/zsy018.
  • Ruan H, Xun P, Cai W, He K, Tang Q. Habitual sleep duration and risk of childhood obesity: systematic review and dose-response meta-analysis of prospective cohort studies. Sci Rep. 2015 Nov 5;5:16160. doi: 10.1038/srep16160.
  • Broussard JL, Chapotot F, Abraham V, Day A, Delebecque F, Whitmore HR, Tasali E. Sleep restriction increases free fatty acids in healthy men. Diabetologia. 2015 Apr;58(4):791-8. doi: 10.1007/s00125-015-3500-4.
  • Karpe F, Dickmann JR, Frayn KN. Fatty acids, obesity, and insulin resistance: time for a reevaluation. Diabetes. 2011 Oct;60(10):2441-9. doi: 10.2337/db11-0425.
  • Spiegel K, Tasali E, Leproult R, Van Cauter E. Effects of poor and short sleep on glucose metabolism and obesity risk. Nat Rev Endocrinol. 2009 May;5(5):253-61. doi: 10.1038/nrendo.2009.23.
  • Huang Y, Cai X, Chen P, Mai W, Tang H, Huang Y, Hu Y. Associations of prediabetes with all-cause and cardiovascular mortality: a meta-analysis. Ann Med. 2014 Dec;46(8):684-92. doi: 10.3109/07853890.2014.955051.
  • Endothelial Dysfunction. Cleveland Clinic. Dec 5, 2022. Available at: https://my.clevelandclinic.org/health/diseases/23230-endothelial-dysfunction.
  • Groh CA, Faulkner M, Getabecha S, Taffe V, Nah G, Sigona K, McCall D, Hills MT, Sciarappa K, Pletcher MJ, Olgin JE, Marcus GM. Patient-reported triggers of paroxysmal atrial fibrillation. Heart Rhythm. 2019 Jul;16(7):996-1002. doi: 10.1016/j.hrthm.2019.01.027.
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There are 65 citations in total.

Details

Primary Language English
Subjects Cardiovascular Medicine and Haematology (Other)
Journal Section Reviews
Authors

Mayank Dhalani 0009-0003-8823-6076

Mounika Tunguntala This is me 0000-0002-2907-1983

Priyanka Aggarwal This is me 0009-0009-8541-6016

Fnu Anamika 0000-0003-1339-0266

Dharti Dua This is me 0000-0001-9556-8894

Bhupinder Singh This is me 0009-0004-9218-0885

Publication Date January 29, 2025
Submission Date May 29, 2024
Acceptance Date September 16, 2024
Published in Issue Year 2025 Volume: 7 Issue: 1

Cite

EndNote Dhalani M, Tunguntala M, Aggarwal P, Anamika F, Dua D, Singh B (January 1, 2025) Exploring the Silent Connection Between Sleep Disorders (i.e., OSA, Insomnia) and Cardiovascular Diseases: Pathophysiology and Insights. Turkish Journal of Internal Medicine 7 1 1–11.

e-ISSN: 2687-4245 

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