The impact of sleep disorders on the formation and course of cardiovascular diseases. Review

Abstract

It is well known that several common mechanisms of pathogenesis make the basis of formation of sleep disorders, hypertension, and type 2 diabetes mellitus (DM 2). First of all, one should take into account possible activation of the sympathoadrenal system, which underlies both the pathogenesis of hypertension and always accompane lack of quality sleep. It has been established that markers of systemic inflammation are raised in both chronic sleep disorders and hypertension and DM 2. Another unifying factor is the increase in aldosterone levels, which is characteristic of both sleep disorders and hypertension and DM 2. A number of studies have demonstrated the role of endothelial dysfunction in the development of chronic sleep disorders. Eating disorders, such as eating high‑calorie meals at bedtime, are both a risk factor for diabetes and sleep disorders. Normally, there are circadian rhythms of blood pressure regulation and insulin production and secretion, which can be observed in circadian sleep disorders. An important factor that contributes to the formation of sleep disorders in patients with hypertension and diabetes is the increase in anxiety and depression, which also often accompany both conditions.At the same time, it has not been established which factors exactly cause insomnia development in patients with hypertension and diabetes. Thereare no data on the occurrence of various sleep disorders in this group of patients in the Ukrainian population, the role of stress hormones in formation of chronic sleep disorders hasn’t been investigated. The most important factor from the point of view of a practitioner is the data on the effects of medicinal products for the treatment of hypertension and diabetes on sleep quality. The role of non‑medicinal correction, such as teaching patients the basics of sleep hygiene in the treatment and prevention of sleep disorders, has not been studied.Thus, insomnia can act as both risk factor for hypertension and diabetes mellitus and often accompany them, significantly affecting the quality of life of patients, treatment effectiveness, and prognosis in this group of patients.