doi CuSleep and Cardiovascular Disease

Abstract: Sleep is an important modulator of cardio-vascular function, both in physiological conditions and in disease states. In individuals without a pri-mary sleep disorder, sleep may exert significant effects on the autonomic nervous system, systemic hemodynamics, cardiac function, endothelial func-tion, and coagulation. Some of these influences can be directly linked to specific modulatory effects of sleep stages per se; others result from the natural circadian rhythm of various physiological processes. There is a temporal association between physiologi-cal sleep and occurrence of vascular events, cardiac arrhythmias, and sudden death. Epidemiological and pathophysiological studies also indicate that there may be a causal link between primary sleep abnor-malities (sleep curtailment, shift work, and sleep-disordered breathing) and cardiovascular and met-abolic disease, such as hypertension, atherosclerosis, stroke, heart failure, cardiac arrhythmias, sudden death, obesity, and the metabolic syndrome. Finally, sleep disturbances may occur as a result of several medical conditions (including obesity, chronic heart failure, and menopause) and may therefore contribute to cardiovascular morbidity associated with these con-ditions. Further understanding of specific pathophysi-ed K. Somers is a consultant for Respironics and has received research funding from the ResMed ndation. authors have no other conflicts of interest to disclose. authors are supported by NIH Grants HL61560, HL65176, HL73211, and M01-RR00585, and th