The implications of maternal sleep disruption on cardiovascular adaptations and cardiometabolic outcomes

Pregnancy involves profound physiological changes that, although necessary for gestation, might promote maladaptive systemic responses, an important consideration given rising maternal morbidity and mortality in the USA, and the role of cardiovascular disease as a leading cause of pregnancy-related death. This Personal View examines the link between disrupted peripartum sleep and adverse cardiometabolic outcomes. Sleep quality and duration often decline during pregnancy because of many factors, including hormonal changes, physical discomfort, and behavioural influences. Sleep pathologies, such as insomnia and sleep-disordered breathing, also become more common as pregnancy progresses. The transition from pregnancy to postpartum introduces a unique set of stressors, including newborn care and novel social demands and restrictions, which frequently compromise sleep quality. Persistent sleep disruption, during pregnancy or otherwise, should not be overlooked, as emerging evidence links poor sleep with increased inflammation, altered autonomic regulation, and impaired metabolic function. In the context of pregnancy, such processes are closely linked to the development of hypertensive disorders of pregnancy, gestational diabetes, and increased cardiovascular risk across the lifespan. Although the number of studies assessing the role of sleep are increasing, important gaps remain in defining optimal perinatal sleep and identifying effective interventions to improve maternal sleep. Greater attention to sleep health within routine perinatal care, along with continued research in this area, is an important step towards improving maternal cardiovascular outcomes.