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CC BY-NC-ND 4.0 · Sleep Sci 2021; 14(01): 55-63
DOI: 10.5935/1984-0063.20200025
Reviews

Insomnia and circadian misalignment: an underexplored interaction towards cardiometabolic risk

Autor*innen

  • Barbara Nobre

    1   Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Sleep Unit - Lisbon - Portugal.

  • Isabel Rocha

    2   Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Cardiovascular Autonomic Function Lab - Lisbon - Portugal.

  • Charles M. Morin

    3   Laval University, Psychology - Québec - Québec - Canada.

  • Miguel Meira e Cruz

    1   Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Sleep Unit - Lisbon - Portugal.
    4   Faculdade São Leopoldo Mandic, Laboratory of Neuroimmune Interface of Pain Research - Campinas - Sao Paulo - Brazil.
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Insomnia remains the most prevalent sleep disorder worldwide, and its pathophysiology suggests an interface with circadian rhythm sleep-wake disorders (CRSWDs). Some epidemiological studies have linked insomnia and circadian misalignment with adverse cardiometabolic outcomes, but the mechanisms underlying this relationship are still unclear. The autonomic nervous system (ANS) has been pointed out as a crucial/key mediator that triggers cardiometabolic risk. Therefore, a critical review of the literature focused on the past ten years was conducted to highlight the relationship between insomnia, circadian misalignment and cardiometabolic risk, with particular emphasis on the influence of the ANS. Shift work, as a model of circadian misalignment, was shown to increase both cardiovascular and metabolic risk and so may integrate a proof of concept on this link. Furthermore, there is good evidence from previous studies supporting that cardiac autonomic dysfunction is indeed a possible mechanism that potentiates cardiometabolic risk in insomniacs and individuals with a misalignment of the circadian timing system (e.g., shift workers), via changes in autonomic variables. Further research is however required in order to definitively establish this interactive relationship.

Insomnia - Circadian Misalignment - Cardiometabolic Risk - Shift-Work - Autonomic Nervous System


Publikationsverlauf

Eingereicht: 30. März 2020

Angenommen: 03. Juni 2020

Artikel online veröffentlicht:
30. November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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