Cited by 88Sleep and related disordersSleep and Work-Related FatigueCircadian rhythm and melatonin

The DOI matches its Crossref record; 339 of the 344 references it cites were found in a registry or an index; none of the 138 sources its claims cite is checked for support yet.

Addressing sleep disturbances: An opportunity to prevent cardiometabolic disease?

Open access
Grandner, Michael A.·2014·International Review of Psychiatry

Abstract

There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although sub-clinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of 'cardiometabolic disease' and 'sleep disturbance' are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review synthesizes evidence linking sleep disturbances—short/long sleep, insomnia, poor sleep quality, circadian disruption, and sleep-disordered breathing—to cardiometabolic disease risk. It argues that sleep should be treated as a public-health behaviour and proposes a social-ecological framework and research agenda, though causal and intervention evidence remains limited.

Key findings

  • Short and long sleep duration have been associated with increased mortality across approximately 50 years and approximately 50 studies; short sleep is linked to obesity, diabetes, hypertension, dyslipidemia, inflammation, heart attack, and stroke, while long sleep shows mixed but adverse associations.
  • In a meta-analysis, insomnia overall was associated with a 5% increased risk of incident hypertension; middle insomnia was associated with a 20% increased risk and late insomnia with a 14% increased risk. Among >85,000 women in the Women’s Health Initiative, insomnia symptoms were associated with a 19% increased risk of coronary heart disease and an 11% increased risk of cardiovascular events.
  • General sleep disturbance in the 2006 BRFSS was associated with a 35% increased risk of obesity, 54% increased risk of diabetes, 80% increased risk of heart attack, 102% increased risk of stroke, and 98% increased risk of any coronary artery disease; relationships attenuated after adjustment, and diabetes/stroke were no longer significant when overall physical health was entered.
  • Social patterning was inconsistent: in NHANES 2007–2008, Black/African-American adults were 58% more likely to report sleep latency >30 min, but less likely to report difficulty falling asleep (OR = 0.57), as were Mexican-Americans (OR = 0.59) and other Hispanics/Latinos (OR = 0.73).

Methods

  • Narrative review, not a systematic review or meta-analysis; it synthesizes existing epidemiologic and clinical literature on operational definitions of cardiometabolic disease and sleep disturbance, including short/long sleep, insufficient sleep, insomnia, general sleep disturbance, circadian rhythm abnormalities, and sleep-disordered breathing.
  • Discusses social/behavioural context (race/ethnicity, socio-economic position, environment), conceptualizes sleep as a domain of health behaviour using a social-ecological model, reviews health behaviour change models, and proposes a future research agenda. No primary data collection or formal meta-analysis was conducted by the author.

Limitations

  • Stated: “sleep disturbance” is non-specific and difficult to assess with conceptual and methodological clarity; most epidemiologic studies use non-standardized survey items, retrospective/subjective measures, and cross-sectional designs, limiting causal inference.
  • Stated: there are no intervention studies for general sleep disturbance, and no studies investigating whether insomnia treatment improves cardiometabolic outcomes; sleep apnoea treatment has some evidence for improved cardiovascular outcomes.
  • Evident from the text: as a narrative review, it does not describe a systematic search strategy or formal quality appraisal, so conclusions rely on cited literature and may be subject to selection or reporting bias.

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

Integrity signals

Registry

Crossref · 10.3109/09540261.2014.911148

Cites

339 of 339 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

100 Not checked yet · 20 Own interpretation · 11 No basis given

Verify all 138 references — free account

Show all 87 claims

  • It may state two separate claims as one. 22
  • Probably not a substantial claim. 24
44 of 44
  • The paper relies on this without support.

    Cardiometabolic disease can be postponed or prevented using lifestyle behavioural approaches that would likely include healthy sleep.

    “Since cardiometabolic disease can be postponed or prevented using lifestyle behavioural approaches (that would likely include healthy sleep), these are the focus of this review.”
  • The paper relies on this without support.

    For epidemiological data collections, general sleep disturbance has generally been the only way to assess sleep at a population level.

    “For epidemiological data collections, this has generally been the only way to assess sleep at a population level.”
  • The paper relies on this without support.

    Sleep disturbances are prevalent.

    “Given that these sleep disturbances are prevalent and are associated with important clinical outcomes, it is important to consider the broader public health implications.”
  • The paper relies on this without support.

    Unhealthy behaviours such as poor diet, sedentary lifestyle, and smoking are complex and resistant to change.

    “These models are necessary because unhealthy behaviours (such as poor diet, sedentary lifestyle, smoking) are complex and resistant to change.”
4 of 4

Claims other papers make about this one

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Self-check

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

1 of 1

Citations

Cites

Research works printed but not linked: 15

  1. Aurora R.N., 2012, Sleep, 35, 1039
  2. Besteiro Gonzalez J.L., 2011, Psicothema, 23, 368
  3. Gamaldo A.A., 2013, Journal of Gerontology B: Psycholical Science and Social Science
  4. Gehrman P.R., 2010, Principles and Practice of Geriatric Sleep Medicine, 384
  5. Grandner M.A., 2013, Journal of Clinical Sleep Medicine, 9, 897, 10.5664/jcsm.2990 · DOI · Paper page
  6. Hall M.H., 2009, Sleep, 32, 73
  7. Killgore W.D.S, 2010, Human Sleep and Cognition, Part I: Basic Research, 105
  8. Laugsand L.E., 2013, European Heart Journal
  9. Markwald R.R., 2013, Proceedings of the National Academy of Science of the United States of America, 110, 5695
  10. Martinez D., 2010, Indian Journal of Medicine Research, 131, 141
  11. McKnight-Eily L.R., 2009, Morbidity and Mortality Weekly Reports, 58, 1175
  12. Miller N.L., 2012, Sleep, 35, 1123
  13. Prochaska J.O., 2008, Health Behavior and Health Education: Theory, Research, and Practice, 97
  14. Stephens S., 2014, Preventive Medicine
  15. Wetter T.C, 2010, Sleep Disorders in Neurology: A Practical Approach, 87

Cited by

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Metadata

Authors
Grandner, M. A.
Affiliations
University of Pennsylvania (US)
Corresponding author
Grandner, Michael A.
Venue
International Review of Psychiatry
Published
2014-04
Volume
26
Issue
2
Pages
155-176
ISSN
  • 0954-0261 (ISSN-L)
  • 1369-1627
OpenAlex
W2163768179
Cited by
88
References
344
Citations by year
2026: 1 · 2025: 8 · 2024: 7 · 2023: 4 · 2022: 16 · 2021: 7 · 2020: 10 · 2019: 8 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 9
FWCI
0.99
Type
journal article
Language
en
Open access
Locations
  • International Review of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000003)
  • National Heart, Lung, and Blood Institute (K23HL110216)
  • National Institute of Environmental Health Sciences (R21ES022931)
  • National Center for Research Resources (UL1RR024134)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
sleep disorders, cardiometabolic disease, insufficient sleep duration, sleep quality, insomnia, circadian rhythm disruption, sleep-disordered breathing, race and ethnicity, socioeconomic status, prevention
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Humans, Obesity, Risk Factors, Sleep Apnea Syndromes, Sleep Wake Disorders, Socioeconomic Factors

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