insights

Read Time: 3 Minutes

Healthy sleep habits are essential for optimal health and wellness, yet approximately one third of US adults get less than the recommended amount of sleep.¹ Not getting the sleep that you need, called sleep deprivation, may negatively impact both behavior and physiology. Studies have associated chronic sleep deprivation with increased risk of cardiovascular events and mortality.² Poor sleep quality, which may be described as short sleep (less than seven hours per 24-hour period), fragmented sleep, or a sleep disorder such as insomnia or sleep apnea has also been linked to cardiovascular disease (CVD) and metabolic syndrome.^3-7

What lifestyle therapies for better sleep may help prevent cardiometabolic damage and improve health?

Sleep Durations & Disorders: Health Effects

Recent studies have found that among adults, both short (less than six hours) and long sleep (greater than eight hours) may increase the risk of metabolic syndrome by 15% and 19%, of obesity by 14% and 15%, and of high blood pressure by 16% and 13%, respectively.⁷ Other recent studies have also suggested that both short and long sleep durations are associated with a higher risk of stroke incidence and stroke mortality⁵ and may contribute to early stages of CVD.⁸

Insomnia

Insomnia is a common sleep disorder, with an estimated 14.5% of US adults reporting difficulties falling asleep and 17.8% of US adults reporting trouble staying asleep.⁹ Insomnia has been linked to a higher risk of hypertension, increased adiposity, and type 2 diabetes in some studies.^10,11 In addition, studies suggest that people experiencing insomnia had a 69% higher risk of a heart attack compared to those without insomnia, especially those sleeping five hours or less.⁴

Obstructive Sleep Apnea

Sleep-disordered breathing like obstructive sleep apnea (OSA) leads to fragmented night sleeping and daytime sleepiness, and evidence suggests that OSA may be associated with the development of a range of cardiovascular diseases.^6,12 While multiple cardiovascular conditions are associated with OSA, the relationship with hypertension, or high blood pressure, has been most clearly established.^12,13 Studies suggest that patients with OSA may have more cardiovascular damage, measured by higher rates of hardened or thickened arteries caused by plaque buildup.¹⁴ OSA also has links to prediabetes and diabetes.¹⁵

Healthy Sleep Habits & the Functional Medicine Approach

Many study results highlight the importance of healthy sleep habits for cardiometabolic and overall health. Several lifestyle-based approaches may promote sleep and help the body heal from insufficient sleep, such as:

• A nutritious diet¹⁶
• Physical exercise¹⁷
• Cognitive-behavioral interventions¹⁸
• Relaxation techniques¹⁸

Specific to nutrition, several nutrient deficiencies have been associated with shorter sleep duration.¹⁹ Increasing evidence also demonstrates a reverse relationship, with disrupted sleep patterns prompting unhealthy eating behaviors^20,21 that may contribute to cardiometabolic risk.

A close working relationship between clinician and patient can help identify sleep troubles early on so that they may be targeted with behavioral and lifestyle therapies such as those listed above to help prevent or reverse cardiometabolic damage. Functional medicine practitioners collaborate with patients to develop personalized therapeutic strategies that focus on the root causes of health conditions and concerns, including sleep disturbances. The functional medicine approach looks at the whole patient, including lifestyle choices and preferences related to diet and exercise to assess the body’s complex processes.

Click below to find a functional medicine practitioner near you and learn more about lifestyle-based treatments that support your sleep and your health.

Related Content

Micronutrient Deficiencies, Inflammatory Diets, and Cardiovascular Health

Exercise Routines: Movement for a Fit Heart

References

1. National Center for Chronic Disease Prevention and Health Promotion. FastStats: sleep in adults. Centers for Disease Control and Prevention. Reviewed May 15, 2024. Accessed October 22, 2024. https://www.cdc.gov/sleep/data-research/facts-stats/adults-sleep-facts-and-stats.html
2. Wang Y-H, Wang J, Chen S-H, et al. Association of longitudinal patterns of habitual sleep duration with risk of cardiovascular events and all-cause mortality. JAMA Netw Open. 2020;3(5):E205246. doi:1001/jamanetworkopen.2020.5246
3. Huang BH, Del Pozo Cruz B, Teixeira-Pinto A, Cistulli PA, Stamatakis E. Influence of poor sleep on cardiovascular disease-free life expectancy: a multi-resource-based population cohort study. BMC Med. 2023;21(1):75. doi:1186/s12916-023-02732-x
4. Dean YE, Shebl MA, Rouzan SS, et al. Association between insomnia and the incidence of myocardial infarction: a systematic review and meta-analysis. Clin Cardiol. 2023;46(4):376-385. doi:1002/clc.23984
5. Wang H, Sun J, Sun M, Liu N, Wang M. Relationship of sleep duration with the risk of stroke incidence and stroke mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Sleep Med. 2022;90:267-278. doi:1016/j.sleep.2021.11.001
6. Salari N, Khazaie H, Abolfathi M, et al. The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis. Neurol Sci. 2022;43(1):219-231. doi:1007/s10072-021-05765-3
7. Che T, Yan C, Tian D, Zhang X, Liu X, Wu Z. The association between sleep and metabolic syndrome: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2021;12:773646. doi:3389/fendo.2021.773646
8. Pomeroy A, Pagan Lassalle P, Kline CE, Heffernan KS, Meyer ML, Stoner L. The relationship between sleep duration and arterial stiffness: a meta-analysis. Sleep Med Rev. 2023;70:101794. doi:1016/j.smrv.2023.101794
9. Adjaye-Gbewonyo D, Ng AE, Black LI. Sleep difficulties in adults: United States, 2020. NCHS Data Brief. 2022;(436):1-8. Accessed October 22, 2024. https://www.cdc.gov/nchs//data/databriefs/db436.pdf
10.  Johnson KA, Gordon CJ, Chapman JL, et al. The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: a systematic review and meta-analysis. Sleep Med Rev. 2021;59:101456. doi:1016/j.smrv.2021.101456
11.  Hayes BL, Vabistsevits M, Martin RM, Lawlor DA, Richmond RC, Robinson T. Establishing causal relationships between sleep and adiposity traits using Mendelian randomization. Obesity (Silver Spring). 2023;31(3):861-870. doi:1002/oby.23668
12.  Tietjens JR, Claman D, Kezirian EJ, et al. Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. J Am Heart Assoc. 2019;8(1):e010440. doi:1161/JAHA.118.010440
13.  Yuan F, Zhang S, Liu X, Liu Y. Correlation between obstructive sleep apnea hypopnea syndrome and hypertension: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(12):12251-12261. doi:21037/apm-21-3302
14.  Lu M, Wang Z, Zhan X, Wei Y. Obstructive sleep apnea increases the risk of cardiovascular damage: a systematic review and meta-analysis of imaging studies. Syst Rev. 2021;10(1):212. doi:1186/s13643-021-01759-6
15.  Wang C, Tan J, Miao Y, Zhang Q. Obstructive sleep apnea, prediabetes and progression of type 2 diabetes: a systematic review and meta-analysis. J Diabetes Investig. 2022;13(8):1396-1411. doi:1111/jdi.13793
16.  Delpino FM, Figueiredo LM, Flores TR, et al. Intake of ultra-processed foods and sleep-related outcomes: a systematic review and meta-analysis. Nutrition. 2023;106:111908. doi:1016/j.nut.2022.111908
17.  De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: a systematic review and meta-analysis. Psychoneuroendocrinology. 2022;143:105843. doi:1016/j.psyneuen.2022.105843
18.  Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17(2):263-298. doi:5664/jcsm.8988
19.  Frank S, Gonzalez K, Lee-Ang L, Young MC, Tamez M, Mattei J. Diet and sleep physiology: public health and clinical implications. Front Neurol. 2017;8:393. doi:3389/fneur.2017.00393
20.  Zerón-Rugerio MF, Doblas-Faxeda S, Diez-Hernández M, Izquierdo-Pulido M. Are emotional eating and other eating behaviors the missing link in the relationship between inadequate sleep and obesity? A systematic review. Nutrients. 2023;15(10):2286. doi:3390/nu15102286
21.  Gomes S, Ramalhete C, Ferreira I, Bicho M, Valente A. Sleep patterns, eating behavior and the risk of noncommunicable diseases. Nutrients. 2023;15(11):2462. doi:3390/nu15112462