Insomnia and cardiometabolic disease risk

This chapter focuses on the association between insomnia and cardiometabolic disease risk, including hypertension, blood pressure dipping, impaired heart rate variability, type 2 diabetes, cardiovascular disease, and cerebrovascular disease as well as their associated mortality risk. This chapter also reviews the potential pathophysiologic mechanisms and health behaviors involved in the increased cardiometabolic risk associated with insomnia. Furthermore, this chapter reviews emerging data indicating that the association of insomnia with cardiometabolic disease risk is stronger in the insomnia with objective short sleep duration phenotype. Finally, this chapter discusses the public health and clinical implications of these associations, including the need for better screening of insomnia in the general population, preventive community-level interventions, and randomized clinical trials to determine whether cognitive-behavioral or pharmacological therapies for insomnia lead to improvement of subclinical and prognostic markers of cardiometabolic disease risk.