Sleep and Cardiometabolic Health: Integration Into Internal Medicine Practice

Sleep is a critical and often underestimated determinant of cardiometabolic health, influencing neuroendocrine, inflammatory, and metabolic pathways. Sleep disorders are associated with an increased risk of cardiovascular and metabolic diseases, including hypertension, type 2 diabetes, and obesity. This article aims to review the main pathophysiological mechanisms linking sleep to cardiometabolic disease, summarize the most recent clinical evidence, and propose intervention strategies applicable to Internal Medicine practice. We conducted a narrative review of literature published between 2015 and 2025, including observational studies, clinical trials, meta-analyses, and international guidelines, with a focus on content relevant to Internal Medicine settings. Recent studies report that high-risk sleep patterns are associated with a 30-60% increased risk of cardiovascular events. Interventions like cognitive behavioral therapy for insomnia (CBT-I), continuous positive airway pressure (CPAP), and sleep hygiene education have demonstrated clinical benefit. Systematic evaluation and targeted intervention on sleep should be incorporated into the internist's routine care. Recognizing sleep as a modifiable risk factor is essential for evidence-based, patient-centered care.