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Sleep and Cardio-Metabolic Disease: Physiological and Clinical Interactions and Implications for Population Health
Healthy sleep is fundamental for cardio-metabolic health. In health, sleep-related changes in the autonomic nervous system (ANS) and neuro-humoral functions result in reductions in heart rate, blood pressure and cortisol. In contrast, disturbed sleep adversely affects acute and chronic cardiovascular functions through mechanisms that include blood pressure surges and vascular injury, increased cardiac oxygen demand and ischemia, and cardiac electrical instability, as well as by altering eating behaviors and metabolism, leading to obesity and metabolic dysfunction. There are multiple sleep-related stressors relevant for cardio-metabolic function: short sleep duration, poor sleep quality (insomnia), altered sleep architecture (reduced slow wave sleep) and variable sleep patterns, as well as circadian misalignment. Common sleep disorders- obstructive sleep apnea, insomnia, and periodic limb movements- also each pose specific cardio-metabolic stressors (such as hypoxemia). Sleep and cardio-metabolic diseases share common risk factors and are inter-related by causal and bi-directional pathways. This talk will review the range of sleep-related stresses as they relate to cardio-metabolic health; identify new biomarkers for sleep health/disturbance; and discuss the scientific and public health implications of sleep on cardio-metabolic health.
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Susan Redline, MD, MPH, is the Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School. She directs Programs in Sleep and Cardiovascular Medicine and Sleep Medicine Epidemiology at Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center. Dr. Redline’s research includes epidemiological studies and clinical trials designed to 1) elucidate the etiologies of sleep disorders, including the role of genetic and early life developmental factors; and 2) understand the cardiovascular and other health outcomes of sleep disorders and the role of sleep interventions in improving health. She leads the Sleep Reading Center for a number of major NIH multicenter studies, including the Sleep Heart Health Study, and has led several large cohort studies, including the Cleveland Children’s Sleep and Health Study. She has published over 500 peer-reviewed articles and has served the sleep research community in a number of capacities, including as a member of the Boards of Directors for the American Academy of Sleep Medicine and the Sleep Research Society, the NIH’s Sleep Disorders Research Advisory Board, the Institute of Medicine’s Committee on Sleep Medicine and Research, and Deputy Editor for the journal Sleep. She received BS and M.D. degrees from Boston University, an MPH degree from Harvard School of Public Health, completed internal medicine and pulmonary and critical care medicine training at Case Western Reserve University, and a research fellowship in Respiratory Epidemiology at Harvard Medical School.