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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
Summary
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.
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.
Keywords:
atrial fibrillationbenzodiazepinescardiovascular diseaseinsomniamyocardial infarctionstrokeMore Related Videos
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