Sleep Deprivation: Cardiovascular and Metabolic Effects

Sleep deprivation has been associated with significant adverse cardiovascular consequences. Contributing to this association is the development of hypertension, diabetes, and obesity, each of which can be linked with sleep deprivation. Numerous epidemiological studies conducted around the world have noted a correlation between cardiovascular disease and sleep deprivation. This association appears to be stronger in women. Mechanisms that explain this association include endothelial dysfunction and systemic inflammation, which have been experimentally associated with sleep deprivation. Additionally, increased sympathetic nervous system activity and decreased coronary flow velocity reserve are likely to contribute to the sleep deprivation associated cardiovascular disease. Similar mechanisms underlie the association of sleep deprivation and the development of hypertension. Obesity and diabetes mellitus also appear to be associated with sleep deprivation, with hormonal aberrations being the primary contributors to the association. Obesity may be associated with sleep deprivation-related reduced levels of leptin and elevated levels of ghrelin, both of which cause appetite stimulation, especially for carbohydrate rich food. Alteration in levels of growth hormone, cortisol, and thyroid stimulating hormone due to sleep deprivation affects glucose metabolism, likely leading to the development of impaired glucose tolerance and diabetes mellitus.