Association between sleep deficiency and cardiometabolic disease: implications for health disparities

• Experimental sleep loss is associated with reduced insulin sensitivity.
• Experimental sleep loss is associated with alterations in appetite regulation.
• Experimental sleep loss alters immune function toward a proinflammatory state.
• Observational studies show associations between short sleep and obesity, diabetes.
• Prospective studies link short sleep with incident cardiovascular diseases.

BackgroundCardiometabolic diseases, which include obesity, diabetes, hypertension, and cardiovascular disease, are associated with reduced quality of life and reduced life expectancy. Unfortunately, there are racial/ethnic and socioeconomic disparities associated with these diseases such that minority populations, such as African Americans and Hispanics, and those of lower socioeconomic status, experience a greater burden. Several reports have indicated that there are differences in sleep duration and quality that mirror the disparities in cardiometabolic disease. The goal of this paper is to review the association between sleep and cardiometabolic disease risk because of the possibility that suboptimal sleep may partially mediate the cardiometabolic disease disparities.MethodsWe review both experimental studies that have restricted sleep duration or impaired sleep quality and examined biomarkers of cardiometabolic disease risk, including glucose metabolism and insulin sensitivity, appetite regulation and food intake, and immune function. We also review observational studies that have examined the association between habitual sleep duration and quality, and the prevalence or risk of obesity, diabetes, hypertension, and cardiovascular disease.ConclusionMany experimental and observational studies do support an association between suboptimal sleep and increased cardiometabolic disease risk.