Cited by 166Sleep and related disordersObstructive Sleep Apnea ResearchSleep and Work-Related Fatigue

The DOI matches its Crossref record; 253 of the 262 references it cites were found in a registry or an index; 17 of the 220 sources its claims cite were checked for support.

Sleep: important considerations for the prevention of cardiovascular disease

Open access
Grandner, Michael A., Alfonso-Miller, Pamela, Fernandez-Mendoza, Julio, Shetty, Safal, Shenoy, Sundeep, Combs, Daniel·2016·Current Opinion in Cardiology

Abstract

PURPOSE OF REVIEW: Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. RECENT FINDINGS: Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. SUMMARY: Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review argues that insufficient sleep duration, sleep apnea, and insomnia are important, potentially modifiable risk factors for cardiometabolic disease and cardiovascular mortality. It summarizes epidemiologic, clinical, and laboratory evidence and recommends routine screening and treatment, especially for sleep apnea and insomnia with short sleep duration.

Key findings

  • Habitual short sleep is common and linked to cardiometabolic risk: NHANES 2005–2008 reported <7 h sleep in 37.0% of adults aged 20–39 and 40.3% of those aged 40–59, versus 32% of those over 60; CDC data show >30% of US adults report <7 h. Sleep duration and mortality are U-shaped, with lowest risk at 7–8 h; in 20,432 healthy Dutch adults over 12 years, ≤6 h sleep was associated with 15% higher CVD incidence and 23% higher CHD incidence, and short sleep plus poor subjective sleep with 63% higher CVD and 79% higher CHD risk.
  • Obstructive sleep apnea (OSA) is highly prevalent and associated with cardiovascular disease: AHI ≥5 prevalence was 22% in men and 17% in women across 11 studies, with more recent estimates of 37% in men and 50% in women; prevalence is about 50% in obesity and about 60% for moderate-severe OSA in metabolic syndrome. Severe OSA was linked to fatal cardiovascular events (OR 2.87) and non-fatal events (OR 3.17); hypertension odds were 2.89 for AHI >15, and CPAP improved blood pressure, glycemic control, and some cardiovascular outcomes.
  • Insomnia, especially with objective short sleep, predicts cardiometabolic risk: prevalence ranges from 8–40%; insomnia with PSG-measured sleep <6 h had T2D odds of 2.1–3.0 and hypertension odds of 3.5–5.1 cross-sectionally and 3.8 longitudinally, while insomnia with >6 h sleep was not significantly increased (OR 1.3 and 0.85). Meta-analytic risks included incident hypertension 5–20%, type-2 diabetes about 57%, and MI/CHD 41–55%.
  • Pediatric sleep-disordered breathing and sleep disparities are also implicated: OSA occurs in 1.2–5.7% of children, and 55% of children with hypertension referred for polysomnography had sleep-disordered breathing. Blacks/African-Americans were 3.5 times as likely to report <5 h sleep and twice as likely to report 5–6 h sleep versus non-Hispanic Whites; non-Mexican Hispanics/Latinos were 87% more likely to report very short sleep and 35% more likely short sleep; Asians/Others were 2.5 times as likely to report very short sleep and 67% more likely short sleep.

Methods

  • Design: narrative review summarizing literature across sleep duration, sleep disorders, pediatric populations, and cardiovascular health disparities; no primary data collection.
  • Data/sample: cites laboratory, clinical, and epidemiologic studies, including NHANES, BRFSS, prospective cohorts (e.g., MORGEN, Penn State Adult Cohort), meta-analyses, and randomized trials.
  • Analysis: qualitative synthesis of associations and mechanisms; no systematic search or pooled quantitative analysis is reported.

Limitations

  • Stated: mechanisms linking sleep to morbidity are not completely delineated; future studies are needed to better characterize mechanisms and identify/refine interventions.
  • Stated for cited evidence: many studies are cross-sectional, lack polysomnography, cannot control for sleep-disordered breathing, or have limited follow-up; for example, insomnia–CVD studies were often modest and lacked PSG/SDB control, and OSA–dyslipidemia causality remains unclear.
  • Evident: as a narrative review, it does not report a systematic search strategy, risk-of-bias assessment, or meta-analysis, so conclusions reflect the authors’ selected synthesis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1097/hco.0000000000000324

Cites

253 of 253 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

94 Not checked yet · 19 Own interpretation · 6 No basis given · 5 Partly supported · 4 Sources not found · 1 Supported so far · accuracy not yet measured

Verify all 190 references — free account

Show all 73 claims

  • It may state two separate claims as one. 52
  • Probably not a substantial claim. 6
56 of 56
  • The paper relies on this without support.

    Sleep hygiene therapy alone is not effective in the treatment of insomnia.

    “Interestingly, however, sleep hygiene therapy alone, which targets poor health behaviors, is not effective in the treatment of insomnia.”
1 of 1

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

4 of 4

Citations

Cites

Research works printed but not linked: 1

  1. Whinnery, 2013, Sleep architecture differences between good sleepers and patients with primary insomnia, Sleep, 36, A212

Cited by

Sorted by citations

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Metadata

Authors
Grandner, M. A., Alfonso-Miller, P., Fernandez-Mendoza, J., Shetty, S., Shenoy, S., & Combs, D.
Affiliations
Pennsylvania State University (US)
Corresponding author
Grandner, Michael A.
Venue
Current Opinion in Cardiology
Published
2016-09
Volume
31
Issue
5
Pages
551-565
ISSN
0268-4705 (ISSN-L)
OpenAlex
W2481881625
Cited by
166
References
262
Citations by year
2026: 13 · 2025: 27 · 2024: 24 · 2023: 20 · 2022: 22 · 2021: 15 · 2020: 12 · 2019: 18 · 2018: 7 · 2017: 8
FWCI
1.45
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Northumbria Research Link (Northumbria University) (acceptedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (K23HL110216)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords
sleep, sleep disorders, cardiometabolic disease, cardiovascular disease, insufficient sleep duration, insomnia, sleep apnea, obesity, inflammation, diabetes mellitus, cardiovascular mortality, pediatric sleep disorders, cardiovascular health disparities
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Humans, Obesity, Risk Factors, Sleep, Sleep Wake Disorders

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