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Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
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Insomnia and Cardiovascular Disease: Untangling a Complex Relationship.

Martino F Pengo1,2, Sogol Javaheri3, Giuseppe Maiolino4

  • 1Department of Cardiology, IRCCS Istituto Auxologico Italiano, Milan, Italy.

Journal of Sleep Research
|February 8, 2026
PubMed
Summary
This summary is machine-generated.

Insomnia, a common sleep disorder, is linked to increased cardiovascular disease (CVD) risk. While evidence suggests a causal relationship, more research is needed to confirm if treating insomnia reduces this risk.

Keywords:
atrial fibrillationbenzodiazepinescardiovascular diseaseinsomniamyocardial infarctionstroke

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Genetics

Background:

  • Insomnia affects one-third of adults and is linked to cardiovascular disease (CVD).
  • CVD is a leading cause of global mortality.
  • The relationship between insomnia and CVD requires further investigation.

Purpose of the Study:

  • To review evidence on insomnia as a causal risk factor for CVD.
  • To integrate epidemiological, genetic, and mechanistic data.
  • To assess the impact of insomnia treatment on cardiovascular risk.

Main Methods:

  • Narrative review of prospective cohort studies and meta-analyses.
  • Inclusion of Mendelian randomization studies.
  • Examination of biological mechanisms and treatment trial data.

Main Results:

  • Insomnia is consistently associated with increased risks of hypertension, myocardial infarction, stroke, heart failure, and cardiovascular mortality.
  • Genetic liability to insomnia correlates with higher cardiometabolic risk.
  • Biological mechanisms include autonomic imbalance, HPA axis activation, and inflammation.
  • Evidence for treatment reducing cardiovascular risk is limited; some treatments may pose harm.

Conclusions:

  • Insomnia is a plausible and potentially causal risk factor for CVD.
  • Definitive proof of cardiovascular risk reduction through insomnia treatment is lacking.
  • Further trials are needed to determine if effective insomnia treatment lowers cardiovascular risk.