Sleep and cardiovascular disease: Emerging opportunities for psychology

Abstract

Sleep disturbances and disorders have been implicated in cardiovascular morbidity and mortality. Converging evidence suggests that psychosocial factors that confer risk or resilience to cardiovascular disease (CVD) are also related to sleep. Profound differences in sleep among racial/ethnic minorities compared with non-Hispanic Whites in the United States suggest that sleep, and its interplay with psychosocial factors, may contribute to observed disparities in CVD and in health and functioning more broadly. Less understood is the extent to which sleep and psychosocial factors interact to influence the pathophysiology and clinical course of CVD. This article reviews observational and experimental evidence linking short sleep duration and insomnia, both modifiable sleep disturbances, to CVD, including key physiological mechanisms. Also reviewed is evidence of significant interrelationships among sleep, race/ethnicity, and psychosocial factors known to confer risk or resilience to CVD, including depression, psychological stress, and close interpersonal relationships. It is proposed that a transdisciplinary research framework that integrates knowledge, methods, and measures from the fields of psychology and sleep research may be used to catalyze advances in the prevention and treatment of CVD. Also discussed are promising new directions, expected challenges, and the importance of training in transdisciplinary science and research approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Figure 1.

Conceptual model of the impact of phychosocial factors on the relationship between sleep and sleep disturbances and cardiovascular disease. Dark blue arrow represents the physiological basis of the relationship between sleep and cardiovascular disease; Panel A represents moderation of the relationship between sleep and cardiovascular disease by race/ethnicity; panel B represents the impact of psychosocial factors on sleep; Panel C represents psychosocial factors as mediators of the relationship between sleep and cardiovascular disease; Panel D represents psychosocial factors as moderators of the relationship between sleep and cardiocvascular disease