Sleep and Cardio-Metabolic Disease

Abstract

Purpose of review: This review summarises and discusses the epidemiological evidence suggesting a causal relationship between sleep duration and cardio-metabolic risk and outcomes in population.

Recent findings: Sleep duration is affected by a variety of cultural, social, psychological, behavioural, pathophysiological and environmental influences. Changes in modern society-like longer working hours, more shift-work, 24/7 availability of commodities and 24-h global connectivity-have been associated with a gradual reduction in sleep duration and sleeping patterns across westernised populations. We review the evidence of an association between sleep disturbances and the development of cardio-metabolic risk and disease and discuss the implications for causality of these associations. Prolonged curtailment of sleep duration is a risk factor for the development of obesity, diabetes, hypertension, heart disease and stroke and may contribute, in the long-term, to premature death.

Keywords: Cardiovascular disease; Diabetes; Hypertension; Naps; Obesity; Sleep deprivation.

Fig. 1

Forest plots of the prospective associations between short duration of sleep and the incidence of hypertension in population studies in adults*. *Results are reported as risk ratio and 95% confidence intervals. (Adapted by permission from Macmillan Publishers Ltd.: Meng L et al. Hypertens Res 2013; 36: 985–95) [28]

Fig. 2

Possible mechanistic pathways linking short duration of sleep and adverse cardiovascular health. BP blood pressure, HbA1c haemoglobin A1c, HDL high-density lipoprotein cholesterol, HR heart rate, LDL low-density lipoprotein cholesterol, PAI-1 plasminogen activator inhibitor-1, SNS sympathetic nervous system, SWS slow-wave sleep, Trigs triglycerides. (Adapted with permission from Miller MA, Cappuccio FP. J Hum Hypert 2013; 27: 583–588) [42]