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Discover how sleep optimization supports cardiovascular health and longevity. Learn why quality rest is a key pillar for a healthier heart.
Sleep is often sacrificed in pursuit of productivity or late-night leisure, but it’s one of the body’s most effective ways to heal and recover.
In 2022, the American Heart Association (AHA) updated their “Life’s Simple 7,” which is a framework to help people improve and maintain cardiovascular health, to “Life’s Essential 8,” by adding sleep as a key part of heart health.
This change shows a growing understanding that sleep isn’t just downtime. It’s a biological need that affects every system in the body, especially the heart.
In this article, we’ll look at how sleep supports cardiovascular health, what current research says about its role in preventing disease, and practical ways to improve your sleep for a stronger heart and a longer life.
Starting the workweek may be more stressful than you think. Research links Mondays to a higher risk of heart attacks, strokes, and sudden cardiac death. One study found that the morning blood pressure surge (MBPS) peaked on Mondays at 19.7 mmHg, higher than on most other days:
Only Tuesday showed a similar increase. This spike may partly explain the rise in heart-related events early in the week
During sleep, the body enters a state of physiological repair. Blood pressure decreases, heart rate slows, and breathing becomes more rhythmic. These changes allow the cardiovascular system to rest and recover.
Sleep isn’t just one continuous state. It has five stages that cycle through the night:
Stages N1, N2, and N3 are grouped together as NREM (Non-Rapid Eye Movement) sleep, which makes up about 75% of total sleep. The rest is REM sleep. Each full sleep cycle takes around 90 to 110 minutes, and you typically go through 4 to 5 cycles a night.
REM and non-REM sleep cycles each play different roles. In deep NREM sleep, heart rate slows further and body temperature drops. This phase is when tissue repair, muscle growth, and immune strengthening take place. REM sleep, in contrast, is associated with vivid dreams and increased brain activity. Although the body remains still during REM, heart rate and blood pressure often fluctuate.
Interruptions in these cycles, caused by poor sleep habits, insomnia, or sleep disorders, can place extra stress on the heart.
Your body follows an internal clock known as the circadian rhythm. This 24-hour cycle affects when hormones are released, how blood pressure fluctuates, and even when cardiovascular events are more likely to occur. For example, nearly half of all ischemic strokes occur in the morning.
This is partly due to a natural rise in stress hormones like cortisol during the early hours. These hormones help you wake up, but they also raise your heart rate and tighten blood vessels, which increases blood pressure.
A long-term study looked at stress hormone levels in overnight urine samples. It found that people with higher cortisol levels were more likely to develop high blood pressure over the next 6 to 7 years. The most concerning finding was that each time cortisol levels doubled, the risk of a heart event went up by 90% over the next 11 years.
When circadian rhythms are repeatedly disrupted, the timing of peak cortisol becomes more inconsistent.
Both short and long sleep durations have been linked to several negative health outcomes, including heart disease and early death.
In the US, nearly one-third of adults report sleeping 6 hours or less per night. This trend has been rising over time. At the same time, about 8.5% of adults sleep 9 hours or more per night.
A review of 15 high-quality prospective studies found that people who sleep too little have a 10% higher risk of developing coronary artery disease (CAD) and a 25% higher chance of dying from it. For those who sleep too much, the risk of developing CAD wasn't clearly higher, but the risk of death from the disease went up by 26%.
Irregular sleep durations have also been linked to risk factors for cardiovascular disease (CVD), such as:
One reason is that not getting enough sleep can disrupt how the nervous system regulates stress and relaxation.
As mentioned earlier, during sleep, your body shifts into a more relaxed state. But when you don’t get enough sleep, your body stays in a more "on edge" or alert state, driven by the sympathetic nervous system (the same system responsible for the “fight or flight” response).
Studies using 24-hour blood pressure monitoring show that blood pressure tends to be higher the day after someone doesn’t sleep well, in both people with and without high blood pressure. This suggests that even a single night of poor sleep can have measurable cardiovascular effects the following day.
A recent meta-analysis found that both short sleep (less than 7 hours) and long sleep (9 hours or more) were linked to a 10% higher risk of hypertension in young and middle-aged adults.
There are a few ways sleep duration may be linked to obesity. One is through changes in hormones that control appetite. When you don’t get enough sleep, levels of ghrelin (which makes you feel hungry) go up, while leptin (which signals fullness) goes down. This can make you feel hungrier and crave more food than usual.
Lack of sleep can also affect your eating habits. People who are sleep-deprived are more likely to skip healthy options like fruits and vegetables and choose high-calorie foods instead.
Researchers looked at data from 2,459 adults in the 2015-2016 US National Health and Nutrition Examination Survey (NHANES) and found that people who slept less than 7 hours were 82% more likely to be overweight and 83% more likely to be obese compared to those who got 7-9 hours.
Even those who slept more than 9 hours had a 37% higher chance of being obese.
Among women, the results were even more alarming. Women who slept too little were 2.5 times more likely to be overweight and 2.6 times more likely to be obese compared to normal sleepers. Long sleep in women also raised obesity risk by about 70%.
Poor or irregular sleep can affect how your body handles sugar. When you don’t sleep well, your cells become less sensitive to insulin. This means they don’t absorb sugar from your blood as easily, causing blood sugar levels to stay high. Over time, this can lead to insulin resistance, which often comes before diabetes.
In the Sleep Heart Health study, researchers looked at more than 1,400 adults between ages 53 and 93. People who slept 5 hours or less had a 2.5 times higher risk of diabetes compared to those who slept 7 to 8 hours.
Even sleeping 6 hours was linked to a higher risk, 1.66 times higher for diabetes and 1.58 times higher for impaired glucose tolerance (IGT), a condition that also raises the chance of developing diabetes. People who slept 9 hours or more also had an increased risk of both diabetes and IGT.
Another study of 5,561 adults ages 40 to 75 found similar results. After accounting for factors like diet and physical activity, sleeping just 5 hours raised the odds of having type 2 diabetes by 2.6 times. Meanwhile, sleeping for 12 hours had 1.8 times the odds.
An unhealthy cholesterol and fat profile in your blood (dyslipidemia) is a known sign of artery problems and a major risk factor for heart disease. This includes:
Just like how irregular sleep can lead to obesity by affecting hormones like ghrelin and leptin, it can also increase the risk of unhealthy cholesterol levels through similar hormonal and nervous system changes.
In both cases, poor sleep throws your body out of balance:
Over time, these changes can lead to weight gain, high cholesterol, and a higher risk of heart disease.
Interestingly, catching up on sleep during weekends can help reduce the risk of dyslipidemia. Researchers analyzed data from 4,085 Korean workers who had not been previously diagnosed with dyslipidemia.
Results showed that those who got extra sleep on weekends (less than 2 hours) had a 24% lower chance of having dyslipidemia compared to those who didn't catch up on sleep. However, sleeping more than 2 extra hours didn't show the same benefit.
Improving your sleep doesn’t require a complete lifestyle overhaul. Small adjustments can have a big impact on your heart and overall well-being.
Going to bed and waking up at the same time every day helps regulate your circadian rhythm.
A recent study concluded that having a consistent sleep schedule, both in how long you sleep and when you go to bed, may lower your risk of developing artery disease, such as:
People whose sleep duration varied by more than 2 hours across the week were 33% more likely to have a high level of calcium in their heart arteries. These same people were also 75% more likely to have poor blood flow in their legs (a sign of clogged arteries).
Those who went to bed at very different times each night (a 90+ minute difference) were also more likely to have signs of heart artery calcification.
Caffeine is a stimulant that blocks adenosine, a chemical in your brain that makes you feel sleepy.
According to the American Academy of Sleep Medicine, caffeine stays in your system for a long time, with a half-life of up to five hours. Because of this, they recommend avoiding caffeine for at least six hours before bedtime. So, if you usually sleep at 10:00 p.m., it’s best to stop drinking caffeine by 4:00 p.m.
Alcohol, on the other hand, might make you drowsy at first, but it disrupts your sleep later on. It delays the start of REM sleep and shortens how long it lasts. Even just one or two drinks can have this effect. The more you drink, the more your sleep gets affected. To avoid this, experts suggest stopping alcohol at least three hours before going to bed.
Creating a good sleep environment can make it easier to fall asleep and stay asleep. Start by keeping your bedroom cool, quiet, and dark. A temperature around 65°F (18°C) is ideal for most people. Use blackout curtains or an eye mask if outside light bothers you.
Keep noise to a minimum. If your surroundings are loud, try earplugs or a white noise machine. Make sure your mattress and pillows are comfortable and supportive. It also helps to keep your room clean and clutter-free.
Chronic stress increases cortisol levels and sympathetic nervous activity, which negatively affect sleep and heart health. Practicing mindfulness can reduce nighttime awakenings and lower blood pressure.
Researchers ran a clinical trial with adults around age 66 who had moderate sleep disturbances. They compared a mindfulness meditation program to a sleep hygiene education program to test which program could help improve sleep better. They used the PSQI to measure sleep quality. It gives a total score from 0 to 21, where:
The average sleep score improved more in the mindfulness group (from 10.2 to 7.4) than in the sleep hygiene group (from 10.2 to 9.1). Mindfulness also helped with related problems like insomnia symptoms, depression, and fatigue.
Physical movement uses energy and increases your need for rest. Studies also show that regular exercise helps you spend more time in deep sleep, which is the most restorative stage of the sleep cycle.
At the same time, regular exercise is one of the best things you can do for your heart health. It:
Your body works hard to digest large meals. If you eat too much right before bed, your stomach stays busy when it should be resting.
Late-night eating may also cause blood sugar spikes and affect how your body stores fat. Over time, this may raise the risk of weight gain and insulin resistance. According to a 2024 study, eating after 11:00 p.m. was linked to a higher risk of death, especially from diabetes.
The highest risk was seen in people who ate between midnight and 1:00 a.m., or between 11:00 p.m. and midnight.
There’s now plenty of research showing that using electronic devices at night can mess with your sleep. It can lead to sleep loss, irregular sleep schedules, poor sleep quality, and feeling overly tired during the day.
Exposure to light, especially within two hours of bedtime, can disrupt your body’s natural sleep rhythm.
Screens on phones, tablets, computers, and TVs give off blue light. This type of light has a shorter wavelength and makes you feel more alert compared to softer, warmer light. When you're exposed to blue light at night, your brain thinks it’s still daytime. As a result, it reduces or delays the release of melatonin, the hormone that helps you fall asleep.
Several studies show that sun exposure can help improve your sleep quality and sleep patterns. This is because natural light helps keep your body’s circadian rhythm on track.
Try to spend at least 20-30 minutes outside each day, especially in the morning.
Napping can be helpful for healthy adults. It may bring benefits like:
But naps aren’t for everyone. They can sometimes make it harder to sleep well at night.
In one study, people who took three or more naps over eight days had more nighttime sleep disruptions than those who napped less or not at all. Napping late in the day, closer to bedtime, was also tied to poorer sleep quality compared to naps taken earlier.
A short nap of 20 to 30 minutes is usually best. Try not to nap longer than 30 minutes regularly, as it can leave you feeling groggy. For better results, nap in the early afternoon (before 3 p.m.).
Sleep and heart health are closely connected, but many other factors can affect this relationship. Currently, there are over 80 types of sleep disorders. Some of the most common include:
Each of these can impact how well you sleep, and in turn, may influence your heart health.
If you frequently feel tired despite sleeping 7 to 9 hours, snore loudly, wake up gasping for air, or struggle to stay awake during the day, it might be time to see a sleep doctor.
You could be dealing with a condition like sleep apnea, narcolepsy, or chronic insomnia, all of which require specific interventions. A sleep study (polysomnography) may be recommended to evaluate your brain activity, breathing patterns, oxygen levels, and more during rest.
Early intervention can dramatically improve both your sleep quality and heart health outcomes.
Sleep isn’t just rest. It actively supports your heart and overall health. Whether you’re trying to prevent heart disease, manage a condition, or live longer, getting good sleep is an important step that many people forget.
Even small changes to your sleep routine can help. Better sleep can boost your heart function, improve your mood and energy, and support long-term health.
