A Good Night's Rest: A Contemporary Review of Sleep and Cardiovascular Health

Sleep is increasingly recognized as a significant contributor to the development of cardiovascular disease (CVD). Recent American Heart Association guidelines incorporate sleep duration into the "Life's Essential Eight" framework of ideal cardiovascular health. This article will review the evidence relating sleep duration, regularity, and quality with all-cause and cardiovascular mortality, cardiometabolic syndrome, and coronary artery disease in adults. Short sleep duration is strongly associated with cardiovascular mortality, cardiometabolic risk factors, and coronary artery disease. Limited studies also suggest a possible U-shaped association, with long sleep duration also associated with greater cardiovascular risk. Sleep regularity has emerged as a strong and independent risk factor for CVD-related mortality, cardiometabolic syndrome, and subclinical atherosclerosis. Less is known about the impact of sleep quality on CVD, though a number of observational studies suggest a possible association with metabolic syndrome and subclinical atherosclerosis. This review provides an update of the literature on the cardiovascular impact of sleep for the everyday clinician and highlights gaps in knowledge that warrant future research.