Cited by 315Sleep and related disordersSleep and Work-Related FatigueObstructive Sleep Apnea Research

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Sleep Duration and Cardiovascular Disease Risk

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Covassin, Naima, Singh, Prachi·2016·Sleep Medicine Clinics

DOI 10.1016/j.jsmc.2015.10.007PMC PMC4791534

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Abstract

Inadequate sleep is increasingly pervasive, and the impact on health remains to be fully understood. The cardiovascular consequences alone appear to be substantial. This review summarizes epidemiologic evidence regarding the association between extremes of sleep duration and the prevalence and incidence of cardiovascular diseases. The adverse effects of experimental sleep loss on physiological functions are discussed, along with cardiovascular risk factors that may underlie the association with increased morbidity and mortality. Current data support the concept that inadequate sleep duration confers heightened cardiovascular risk. Thus implementation of preventative strategies may reduce the potential disease burden associated with this high-risk behavior.

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Background
A Meta-Analysis of Sleep Disorders and Nonalcoholic Fatty Liver Disease
Yu, L., Lin, C., Chen, X., Teng, Y., Zhou, S., & Liang, Y. (2022) · Gastroenterology Nursing · doi:10.1097/sga.0000000000000658 · Cited by 7
The Effect of Aerobic Exercise on Variation of Oxidative Stress, hs-CRP and Cortisol Induced by Sleep Deficiency
Park, J.-S., Murlasits, Z., & Kim, S. (2023) · Healthcare · doi:10.3390/healthcare11081201 · Cited by 6
Undergraduates’ lifestyle and Suboptimal Health Status (SHS): A cross-sectional study in the Ha’il region of Saudi Arabia
Alsaif, B. S., Asweto, C. O., Hassan, S.-U.-N., Alzain, M. A., Elshiekh, M., Kassar, A. S. A., Ali, K. E. M., Ghorbel, M., Zrieq, R. M., & Wang, W. (2025) · PLoS ONE · doi:10.1371/journal.pone.0317127 · Cited by 5
Effects of gender and age on sleep EEG functional connectivity differences in subjects with mild difficulty falling asleep
Luo, X., Zhou, B., Shi, J., Li, G., & Zhu, Y. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1433316 · Cited by 5
The Effects of Antioxidant Approved Drugs and Under Investigation Compounds with Potential of Improving Sleep Disorders and their Associated Comorbidities Associated with Oxidative Stress and Inflammation
Theodosis‐Nobelos, P., Varra, F., Varras, M. N., & Rekka, E. A. (2025) · Mini-Reviews in Medicinal Chemistry · doi:10.2174/0113895575360959250117073046 · Cited by 5
The influence of sleep on autonomic nervous system regulation in women across the lifespan
Bigalke, J. A., & Carter, J. R. (2025) · Autonomic Neuroscience · doi:10.1016/j.autneu.2025.103275 · Cited by 5
Evaluating the relationship of sleep quality and sleep duration with Framingham coronary heart disease risk score
Çakır, H., Güneş, A., Er, F., Çakır, H., Karagöz, A., Yılmaz, F., Öcal, L., Zehi̇r, R., Emiroğlu, M. Y., Demir, M., et al. (2022) · Chronobiology International · doi:10.1080/07420528.2021.2018453 · Cited by 5
“Our findings highlight the results of some previous studies demonstrating a U-shaped relation (Cappuccio et al. 2011; Covassin and Singh 2016; Kim et al. 2019; Magee et al. 2012), with short and long sleep durations being associated with increased CHD risk.”
Result
Evaluation of Sleep Behavior and the Use of Sleep Aids among Adults Living in Saudi Arabia: A Cross-Sectional Study
Aldhafiri, A. J., Almutairi, N., Alharbi, M., Aloufi, A., Hakeem, A., Kattan, A., & Alzahrani, F. (2023) · Clocks & Sleep · doi:10.3390/clockssleep5030035 · Cited by 5
Sleep Restriction Effects on BP: Systematic Review & Meta-analysis of RCTs
Hu, S., Jing, S., & Gao, Y. (2019) · Western Journal of Nursing Research · doi:10.1177/0193945919868143 · Cited by 5
“Similarly, an increasing number of studies have reported the adverse impact of inadequate sleep on cardiovascular health including hypertension (Cappuccio & Miller, 2017; Covassin & Singh, 2016; Gangwisch, 2014; Itani et al., 2017; Knutson, 2010).”
Background
The influence of health behaviors upon the association between stress and depression and cardiovascular disease
Goodie, J. L., Wilfong, K. M., & Kroke, P. C. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815015-3.00010-6 · Cited by 5
Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey
Kang, M. J., Lee, Y., Kim, Y. J., Lee, J. G., Lee, J. G., Yi, Y. H., Tak, Y. J., Tak, Y. J., Park, E. J., Kim, G. L., et al. (2023) · Korean Journal of Family Medicine · doi:10.4082/kjfm.22.0137 · Cited by 5
Correlation of plasma metabolites and comorbid illnesses with poor sleep quality in patients with coronary heart disease
Gökçe, E., Arslan, S., & İşler, A. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02835-y · Cited by 5
“In previous explorations of the physiological and epidemiological connections between sleep and CHD, it was shown that sleep exerts crucial effects on the synthesis of many proteins, the secretion of various hormones, and autonomic activities [6].”
Background
Exploring the Silent Connection Between Sleep Disorders (i.e., OSA, Insomnia) and Cardiovascular Diseases: Pathophysiology and Insights
Dhalani, M., Tunguntala, M., Aggarwal, P., Anamika, F., Dua, D., & Singh, B. P. (2025) · Turkish Journal of Internal Medicine · doi:10.46310/tjim.1491486 · Cited by 4
Findings and Methodological Shortcomings of Investigations Concerning the Relationship Between Sleep Duration and Blood Pressure: A Comprehensive Narrative Review
Smolensky, M. H., Hermida, R. C., Castriotta, R. J., & Geng, Y. (2025) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd12030095 · Cited by 4
“…elevated SBP and DBP and incident HTN but because of its linkage to unhealthy behaviors and habits that jeopardize metabolic and vascular health [16,18,19,22,26–28, Although there is clear evidence for the association between HTN with SSD, and to much lesser extent LSD, there is urgent need for…”
Insomnia and Cardiovascular Disease: Untangling a Complex Relationship
Pengo, M. F., Javaheri, S., Maiolino, G., Redline, S. S., & Lombardi, C. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70299 · Cited by 4
“Individuals with insomnia may face an elevated risk of developing CVD and conversely, those with existing cardiovascular conditions may often experience insomnia symptoms (Covassin and Singh 2016; Frøjd et al. 2021).”
Causal relationship between sleep characteristics and thyroid function: A bidirectional Mendelian randomization study
Jia, Z., Li, Z., & Li, Y. (2024) · Medicine · doi:10.1097/md.0000000000040516 · Cited by 4
A systematic review and narrative synthesis of the complex interplay between psychological flexibility and sleep health
Ryan, E. C., O'Neill, D., & Smyth, S. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100871 · Cited by 6
Neuroimmunology and Sleep
Dredla, B. K., & Braley, T. J. (2025) · Seminars in Neurology · doi:10.1055/a-2559-7565 · Cited by 4
Association Between Depression and the Short Sleep Duration on Weekdays and Weekends in South Korean Adults: A Cross-Sectional Study Using the 2016 and 2018 Korea National Health and Nutrition Examination Survey
Eum, M.-J., & Si, E. (2025) · Healthcare · doi:10.3390/healthcare13091043 · Cited by 4
“In particular, unstable labor, long-time work, increased environmental illumination, and increased use of mobile technology and social media have changed an individual’s lifestyle and affected his/her sleep [50].”
RETRACTED CHAPTER: Sleep Deprivation Induced Blood-Brain Barrier Breakdown and Brain Pathology. Neuroprotective Effects of TiO2-Nanowired Delivery of Cerebrolysin and Ondansetron
Sharma, A., Muresanu, D. F., Lafuente, J. V., Ozkızılcık, A., Tian, Z. R., Buzoianu, A. D., & Sharma, H. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-57696-1_5 · Cited by 4
No Decrease in Blood Pressure After an Acute Bout of Intermittent Hyperpnea and Hypoxia in Prehypertensive Elderly
Stutz, J., Oliveras, R., Eiholzer, R., & Spengler, C. M. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.556220 · Cited by 4
“subjects with inadequate sleep duration (Covassin and Singh, 2016) and in snorers (Khazaie et al.”
Background
Association between self-reported sleep duration and cardiometabolic risk in corporate executives
Pienaar, P. R., Roden, L. C., Boot, C. R. L., van Mechelen, W., Twisk, J. W. R., Lambert, E. V., & Rae, D. E. (2021) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-021-01739-2 · Cited by 4
Emerging Technologies and Wearables for Monitoring and Managing Sleep Disorders in Patients with Cardiovascular Disease
Sung, E.-R., Hassan, Z., & Allam, J. S. (2024) · Current Sleep Medicine Reports · doi:10.1007/s40675-024-00280-1 · Cited by 4
“Insufficient sleep duration, fragmented sleep, insomnia, and circadian misalignment, along with sleep-related movement disorders, can also elevate cardiovascular risks [4–10].”
A Dynamic Fitting Strategy for Physiological Models: A Case Study of a Cardiorespiratory Model for the Simulation of Incremental Aerobic Exercise
Sarmiento, C. A., Hernández, A. M., Serna, L. Y., & Mañanas, M. Á. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14040406 · Cited by 4
“Below, the specific implementation details for each procedure are outlined.”
Short Sleep Duration as a Risk Factor of Cardiovascular Disease in Korean Adults: Secondary Analysis of the Fifth Korean National Health and Nutrition Examination Survey
Noh, W., & Moon, H. (2020) · Iranian Journal of Public Health · doi:10.18502/ijph.v48i7.2945 · Cited by 5
“The main objective of present study was to determine the nature of the relationships among sleep duration, the risk factors of HTN, and the presence of CVDs using data produced by the Fifth Korean National Health and Nutrition Examination Survey (KNHANES-V; 2011).”
BackgroundMethodInfluential
Association Between Adverse Childhood Experiences and Sleep Duration in US Children
Song, M., McHill, A. W., Dieckmann, N. F., Musil, C. M., & Hayman, L. L. (2024) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000001128 · Cited by 3
Effects of Sleep Patterns on Cardiovascular Health
Zhao, X., Li, Y., & Wang, T. (2025) · Cardiovascular Innovations and Applications · doi:10.15212/cvia.2025.0022 · Cited by 5
“Furthermore, sleep plays essential roles in regulating blood pressure, weight control, endocrine function, and immune responses, all of which are critical for maintaining cardiovascular health [11–13].”
Multimodal cardiovascular risk profiling using self-supervised learning of polysomnography
He, Z., Li, H., Yuan, G., Killgore, W. D. S., Quan, S. F., Chen, C. X., & Li, A. (2025) · SLEEP · doi:10.1093/sleep/zsaf371 · Cited by 5
Sleep and Cardiovascular Disease
Park, M., Martyn-Nemeth, P. A., & Hayman, L. L. (2021) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000870 · Cited by 3
Overnight Heart Rate Variability During Sleep Disturbance In Peri- And Postmenopausal Women
Virtanen, I., Polo‐Kantola, P., & Kalleinen, N. (2023) · Behavioral Sleep Medicine · doi:10.1080/15402002.2023.2255329 · Cited by 5
“Disturbed sleep has been shown to predict morbidity and mortality in both men and women (Riemann, 2007; Wallander et al., 2007), and chronic sleep disturbances contribute to an increased risk for both cardiovascular and overall morbidity (Covassin & Singh, 2016; Jackson et al., 2015).”
Background
Healthy diet habits attenuate the association of poor sleep quality with nonfatal ischemic stroke: A prospective rural cohort
Zhang, H., Yang, J., Gu, R., Yang, J., Dong, X., Ren, Z., Sun, S., Wang, X., Wei, S., Zhuo, Z., et al. (2024) · Nutrition · doi:10.1016/j.nut.2024.112485 · Cited by 3
Sex differences in the association between sleep duration and muscle quality index in adults: A cross-sectional study from NHANES 2011–2014
Xu, B., Jiang, M., Wei, Y., Duan, R., & Feng, T. (2024) · PLoS ONE · doi:10.1371/journal.pone.0306661 · Cited by 3
Smartphone addiction habit is positively associated with coronary artery disease and its severity in Chinese adults: a case-control study
Zhu, J., Wang, S., Wu, Y., Gu, L., Ma, Y., Wang, Y., & Wang, L. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1374797 · Cited by 3
“On the other hand, people who go to bed late at night were more likely to lack physical activity and become obese, which were closely related to cardiovascular disease (17).”
Background
Mapping the Neural Basis of Wake Onset Regularity and Its Effects on Sleep Quality and Positive Affect
Negelspach, D., Kennedy, K. E. R., Huskey, A., Cha, J., Alkozei, A., & Killgore, W. D. S. (2025) · Clocks & Sleep · doi:10.3390/clockssleep7010015 · Cited by 3
“…meta-analyses show that failure to consistently obtain the recommended 7 to 9 h of sleep per night (for adults) [13] is linked to an increased risk of a range of disorders, including cardiometabolic diseases: heart disease [14–16], obesity [17], and diabetes [18,19] (for reviews, see [20–23]).”
Influence of sleep and cardiovascular health on cognitive trajectories in older adults
Maybrier, H. R., Jackson, J. J., Toedebusch, C. D., Lucey, B. P., & Head, D. M. (2025) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2025.04.008 · Cited by 2
Association of Income Inequality and Sleep Duration With Cardiovascular Outcomes in China and the UK
Li, C., Hua, G., Wang, Y., He, X. M., Jiao, J., Yang, X., Yu, H., & Liu, L. (2025) · JACC Asia · doi:10.1016/j.jacasi.2025.06.013 · Cited by 3
Archetypal physiological responses to prolonged wakefulness
Daley, M. S., Diaz, K., Posada-Quintero, H. F., Kong, Y., Chon, K. H., & Bolkhovsky, J. (2022) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2022.103529 · Cited by 3
Comorbidities and their impact
McDonnell, M. J., Ward, C., & Rutherford, R. M. (2018) · European Respiratory Society eBooks · doi:10.1183/2312508x.10015417 · Cited by 3
The association between sleep duration and detailed measures of obesity: A cross sectional analysis in the ADDITION‐PRO study
Andersen, M. M., Laurberg, T., Bjerregaard, A., Sandbæk, A., Brage, S., Vistisen, D., Quist, J. S., Bruun, J. M., & Witte, D. R. (2022) · Obesity Science & Practice · doi:10.1002/osp4.640 · Cited by 3
Association of Sleep Duration with Physical Performance in Hemodialysis Patients: A Multicenter Cross-Sectional Study
Zhan, Q., Zhao, J., Guo, Q., Niu, J., Chen, Y., Ding, W., Zhang, L., Qi, H., & Shao, X. (2022) · The Nephron journals/Nephron journals · doi:10.1159/000527406 · Cited by 3

Authors: Covassin, N., & Singh, P.
Affiliations: Mayo Clinic (US)
Corresponding author: Covassin, Naima
ORCID: Covassin, Naima
Singh, Prachi
Venue: Sleep Medicine Clinics
Publisher: Elsevier BV
Published: 2016-03
Volume: 11
Issue: 1
Pages: 81-89
ISSN: 1556-407X (ISSN-L)
DOI: 10.1016/j.jsmc.2015.10.007
PMC: PMC4791534
OpenAlex: W2293620633
Cited by: 314
References: 94
Citations by year: 2026: 19 · 2025: 48 · 2024: 49 · 2023: 57 · 2022: 41 · 2021: 29 · 2020: 28 · 2019: 15 · 2018: 17 · 2017: 7 · 2016: 4
FWCI: 1.89
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Sleep Medicine Clinics (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: American Heart Association (11SDG7260046)
National Heart, Lung, and Blood Institute (R01HL114676)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Keywords: sleep duration, cardiovascular disease, insufficient sleep, sleep deprivation, cardiovascular risk factors, cardiovascular mortality, cardiovascular disease incidence, disease prevention
MeSH terms: Cardiovascular Diseases, Humans, Sleep

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Sleep Duration and Cardiovascular Disease Risk

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