Sleep and Internal Medicine: Sleep and Cardiovascular Disease


24 September 2021

Heart failure. Coronary artery disease. Arrhythmias. Hypertension. 

What does any of this have to do with sleep? 

World Heart Day

World Heart Day was created by the World Heart Federation to educate people on cardiovascular disease (CVD) and the actions they can take to prevent and control it. Some of these actions include reducing tobacco use, increasing physical activity and improving one’s diet – which coincidentally also lead to better sleep. 

In recognition of World Heart Day coming up next week – Wednesday, 29-September 2021 we’re highlighting a completely new section of the European Sleep Research Society’s recently published Sleep Medicine Textbook, 2nd Edition, which specifically addresses the interconnection between sleep and CVD. 

Sleep Medicine Textbook

“There is a bidirectional relationship between cardiovascular diseases (CVD), sleep-disordered breathing and quality of sleep. The repeated exposure to biological consequences of obstructive sleep apnea (OSA) including altered blood gas chemistry, arousals and large negative swings in intrathoracic/juxta-cardiac pressure will in the long run lead to a variety of cardiovascular disorders including hypertension, heart failure, arrhythmias, coronary artery disease, and stroke.  

Randomized controlled trials (RCTs) have consistently shown that the treatment of OSA lowers blood pressure, particularly those with resistant hypertension and most adherent to therapy with continuous positive airway pressure (CPAP) devices. However, to date, RCTs have failed to show that therapy with CPAP improves downstream cardiovascular consequences. Notably, the Achilles tendon of these trials has been the lack of adequate adherence to CPAP.  

Central sleep apnea (CSA) frequently occurs in subjects with left ventricular dysfunction, particularly those with heart failure and reduced ejection fraction. The acute consequences of CSA are qualitatively similar to OSA, although less severe. Multiple observational trials have shown the effectiveness of adaptive servoventilation in suppressing CSA. Yet, unlike OSA, a large RCT on cardiovascular outcomes was neutral or even detrimental, showing a lack of effectiveness of treatment with adaptive servoventilation when compared to usual care. Another trial using an adaptive servoventilation device with an updated algorithm is in progress.  

This chapter intends to provide a comprehensive overview of the major cardiovascular consequences of sleep disturbances also pointing to research gaps and perspectives. Several observational studies have shown associations between sleep duration or quality and CVD. Yet, prospective data are not available and the observed relationships may be due to confounders.” 

To dive even further into this topic, we invite you to purchase your very own copy of the Sleep Medicine Textbook 2nd Edition, now available in print and digital versions. 

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Summary by:
Javaheri, S., Drager, L.F., Pevernagie, D.A., and Lorenzi-Filho, G. (2021). K. Sleep and Internal Medicine. 1. Cardiovascular diseases: Heart failure, coronary artery disease, arrhythmias, and hypertension. In Bassetti, C., McNicholas, W., Paunio, T., & Peigneux, P. (Eds.). Sleep Medicine Textbook (2nd ed., pp. 771-787). Regensburg: European Sleep Research Society. 

ESRS Announcements

Sleep Europe 2022 Call for Symposia 

We’d like to invite all members to contribute to the program by proposing a symposium. Submissions are now being accepted until 27 September 2021. Find out more on the criteria and procedures here.  

Research Network Committee Call for an Effective Member

Do you want to step up your contribution to the work of the ESRS? The Research Network Committee (RNC) has re-launched its Call for a New Effective Member.

They’re seeking a Project Manager to investigate the possibilities and eventually set up an ESRS Foundation, to encourage, fund and promote research in the sleep field (basic & clinical).

Applications will be accepted until 30-September. Here’s more information on the project and how to apply.

ESRS Survey

Take the ESRS survey today to help us better serve the present and future needs of the sleep community by first understanding our members. We want to:
  • enhance your membership experience
  • know your role in sleep research & sleep medicine
  • finetune the society’s activities

We invite you to share it with your colleagues, via social media, email and word of mouth.

Take the Survey

Recent publications from ESRS members: 

  1. Stanyer et al. (2021). Subjective Sleep Quality and Sleep Architecture in Patients With Migraine: A Meta-analysis. Neurology.
  2. Spanhel et al. (2021). Effectiveness of an internet-based intervention to improve sleep difficulties in a culturally diverse sample of international students: A randomised controlled pilot study. J Sleep Res.
  3. Lysen et al. (2021). Sleep and perivascular spaces in the middle-aged and elderly population. J Sleep Res.
  4. Korman et al. (2021). Outdoor daylight exposure and longer sleep promote wellbeing under COVID-19 mandated restrictions. J Sleep Res.
  5. Ferri et al. (2021). Leg Movements during Sleep in Children Treated with Serotonergic Antidepressants. Sleep.
  6. Forthun et al. (2021). Sleep medication and melatonin use among Norwegian nurses – A cross-sectional study. Nurs Open.
  7. Lopez et al. (2021). A series of eight cases of sleep-related psychogenic dissociative disorders and proposed updated diagnostic criteria. J Clin Sleep Med.
  8. Gaisl et al. (2021). BAY 2253651 for the treatment of obstructive sleep apnea: a multi-center, double-blind, randomized controlled trial (SANDMAN). Eur Respir J.

Just published an article? Want your research to be featured? Saw something interesting?  Contact us at esrs@esrs.eu.