The Effect of Sleep Deprivation on the Cardiovascular System and Endothelial Function

   Sleep deprivation is a significant risk factor for cardiovascular diseases and has a systemic effect on the body through a complex set of pathogenetic mechanisms. It is known that both acute and chronic sleep deprivation disrupts the autonomic nervous system, increasing sympathetic activity and raising blood pressure and heart rate. Endothelial dysfunction plays a significant role by reducing the bioavailability of nitric oxide and activating adhesion molecules thereby contributing to the development of atherosclerosis and hypercoagulation. We analyzed research papers published in the PubMed, Semantic Scholar, and Cochrane Library databases between 2014 and 2025 using the keywords «sleep deprivation», «endothelium», «vessels», and «cardiovascular disorders». This article highlights modern views on the mechanisms of the negative effect of sleep deprivation on the cardiovascular system. It also presents the results of experimental and clinical studies on the effect of various types of sleep restriction on the functional, biochemical, and morphological parameters of the cardiovascular system, including the endothelium.

1. Liu Y, Wheaton AG, Chapman DP, et al. Prevalence of healthy sleep duration among adults – United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–141. Doi: 10.15585/mmwr.mm6506a1.

2. Gafarov VV, Gromova EA, Panov DO, et al. Dynamics of sleep duration (2003–2018) and the risk of myocardial infarction in an open population aged 45–64 years in Russia/Siberia. Russian Journal of Cardiology. 2022;27(5):4943. (In Russ.) Doi: 10.15829/1560-4071-2022-4943.

3. Ference YuS. Sleep disorders in children aged 14 to 17 years. Modern innovations. 2016;10(12):14–15. (In Russ.)

4. Gazenkampf KA, Omelenchuk RK, Emelyanova VN, et al. Circadian sleep disorders in schoolchildren of countryside Siberia. Russian Journal of Child Neurology. 2017;12(2):40–42. (In Russ.) Doi: 10.17650/2073-8803-2017-12-2-40-42.

5. Zadorozhnaya LV, Makeeva AG, Khomiakova IA. The main characteristics of diet, sleep and physical activity of modern Russian primary school children. Moscow University Anthropology Bulletin. 2018;(2):76–84. (In Russ.) Doi: 10.32521/2074-8132.2018.2.076-084.

6. Al-Wandi AS, Shorbagi SI. Sleep patterns and its relation to lifestyle habits: a study of secondary high school students in Sharjah, United Arab Emirates. AIMS Public Health. 2020;7(3):713–722. Doi: 10.3934/publichealth.2020055.

7. Kovtyuk N, Nechytailo Yu, Nechytailo D, Mikhieieva T. Sleep patterns of school-age children. Pediatrics. Eastern Europe. 2021;9(2):217–223. Doi: 10.34883/PI.2021.9.2.006.

8. Guo C, Piao S, Wang C, et al. The prevalence and associated factors of sleep deprivation among healthy college students in China: a cross-sectional survey. Peer J. 2023;11: e16009. Doi: 10.7717/peerj.16009.

9. Gafarov VV, Gagulin IV, Gromova EA, et al. Depression, anxiety, and sleep disorders in 45–69-year-old population in Russia (Siberia): epidemiological survey. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(4):31–37. (In Russ.) Doi: 10.14412/2074-2711-2017-4-31-37.

10. Arapova YuYu, Verbitskiy YeV, Komarova YeF. Studying the night sleep architecture of men and women with high and low levels of trait anxiety. Effective Pharmacotherapy. 2023;19(41):20–24. (In Russ.) Doi: 10.33978/2307-3586-2023-19-41-20-24.

11. Kohansieh M, Makaryus AN. Sleep deficiency and deprivation leading to cardiovascular disease. Int J Hypertens. 2015;2015:615681. Doi: 10.1155/2015/615681.

12. Liew SC, Aung T. Sleep deprivation and its association with diseases – a review. Sleep Med. 2021;77:192–204. Doi: 10.1016/j.sleep.2020.07.048.

13. Holmer BJ, Lapierre SS, Jake-Schoffman DE, Christou DD. Effects of sleep deprivation on endothelial function in adult humans : a systematic review. Geroscience. 2021; 43(1):137–158. Doi: 10.1007/s11357-020-00312-y.

14. Agaltsov MV, Orlova AA, Drapkina OM. Sleep duration and possible cardiovascular risk. Russian Journal of Preventive Medicine. 2022;25(7):94–99. (In Russ.) Doi: 10.17116/profmed20222507194.

15. Jaspan VN, Greenberg GS, Parihar S, et al. The role of sleep in cardiovascular disease. Curr Atheroscler Rep. 2024;26(7):249–262. Doi: 10.1007/s11883-024-01207-5.

16. Kadoya M, Koyama H. Sleep, autonomic nervous function and atherosclerosis. Int J Mol Sci. 2019;20(4):794. Doi: 10.3390/ijms20040794.

17. Chou LP, Li CY, Hu SC. Work-related psychosocial hazards and arteriosclerosis. Int Heart J. 2015;56(6):644–650. Doi: 10.1536/ihj.15-143.

18. Bochkarev MV, Korostovtseva LS, Sviryaev YuV, Konradi AO. Sleep quality and duration and cardiovascular diseases: is there an association? Arterial Hypertension. 2014;20(5):450–461. (In Russ.) Doi: 10.18705/1607-419X-2014-20-5-450-461.

19. Wang Y, Mei H, Jiang YR, et al. Relationship between duration of sleep and hypertension in adults: a meta-analysis. J Clin Sleep Med. 2015;11(9):1047–1056. Doi: 10.5664/jcsm.5024.

20. Wang D, Li W, Cui X, et al. Sleep duration and risk of coronary heart disease : a systematic review and meta-analysis of prospective cohort studies. Int J Cardiol. 2016;219: 231–239. Doi: 10.1016/j.ijcard.2016.06.027.

21. Yuan R, Wang J, Guo L. The effect of sleep deprivation on coronary heart disease. Chin Med Sci J. 2016;31(4):247–253. Doi: 10.1016/s1001-9294(17)30008-1.

22. Wei R, Duan X, Guo L. Effects of sleep deprivation on coronary heart disease. Korean J Physiol Pharmacol. 2022; 26(5):297–305. Doi: 10.4196/kjpp.2022.26.5.297.

23. Daghlas I, Dashti HS, Lane J, et al. Sleep duration and myocardial infarction. J Am Coll Cardiol. 2019;74(10):1304–1314. Doi: 10.1016/j.jacc.2019.07.022.

24. Morovatdar N, Ebrahimi N, Rezaee R, et al. Sleep duration and risk of atrial fibrillation : a systematic review. J Atr Fibrillation. 2019;11(6):2132. Doi: 10.4022/jafib.2132.

25. Shen X, Wu Y, Zhang D. Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies. Sci Rep. 2016;6:21480. Doi: 10.1038/srep21480.

26. Yin J, Jin X, Shan Z, et al. Relationship of sleep duration with all-cause mortality and cardiovascular events : a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2017;6(9):e005947. Doi: 10.1161/JAHA.117.005947.

27. Wang C, Bangdiwala SI, Rangarajan S, et al. Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries. Eur Heart J. 2019;40(20):1620–1629. Doi: 10.1093/eurheartj/ehy695.

28. Zhong X, Hilton HJ, Gates GJ, et al. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol (1985). 2005;98(6):2024–2032. Doi: 10.1152/japplphysiol.00620.2004.

29. Faraut B, Touchette E, Gamble H, et al. Short sleep duration and increased risk of hypertension: a primary care medicine investigation. J Hypertens. 2012;30(7):1354–1363. Doi: 10.1097/HJH.0b013e32835465e5.

30. Cincin A, Sari I, Oğuz M, et al. Effect of acute sleep deprivation on heart rate recovery in healthy young adults. Sleep Breath. 2015;19(2):631–636. Doi: 10.1007/s11325-014-1066-x.

31. Esen Ö, Akçakoyun M, Açar G, et al. Acute sleep deprivation is associated with increased atrial electromechanical delay in healthy young adults. Pacing Clin Electrophysiol. 2011;34(12):1645–1651. Doi: 10.1111/j.1540-8159.2011.03186.x.

32. Ozer O, Ozbala B, Sari I, et al. Acute sleep deprivation is associated with increased QT dispersion in healthy young adults. Pacing Clin Electrophysiol. 2008;31(8):979–984. Doi: 10.1111/j.1540-8159.2008.01125.x.

33. Cakici M, Dogan A, Cetin M, et al. Negative effects of acute sleep deprivation on left ventricular functions and cardiac repolarization in healthy young adults. Pacing Clin Electrophysiol. 2015;38(6):713–722. Doi: 10.1111/pace.12534.

34. Genuardi MV, Ogilvie RP, Saand AR, et al. Association of short sleep duration and atrial fibrillation. Chest. 2019;156(3):544–552. Doi: 10.1016/j.chest.2019.01.033.

35. Sekine T, Daimon M, Hasegawa R, et al. The impact of sleep deprivation on the coronary circulation. Int J Cardiol. 2010;144(2):266–267. Doi: 10.1016/j.ijcard.2009.01.013.

36. Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med Rev. 2008;12(3):197–210. Doi: 10.1016/j.smrv.2007.07.007.

37. Messa RM, Benfica MA, Ribeiro LFP, et al. The effect of total sleep deprivation on autonomic nervous system and cortisol responses to acute stressors in healthy individuals : a systematic review. Psychoneuroendocrinology. 2024;168:107114. Doi: 10.1016/j.psyneuen.2024.107114.

38. Schlagintweit J, Laharnar N, Glos M, et al. Effects of sleep fragmentation and partial sleep restriction on heart rate variability during night. Sci Rep. 2023;13(1):6202. Doi: 10.1038/s41598-023-33013-5.

39. Tobaldini E, Costantino G, Solbiati M, et al. Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neurosci Biobehav Rev. 2017;74(Pt B):321–329. Doi: 10.1016/j.neubiorev.2016.07.004.

40. Kozhevnikova OV, Namazova-Baranova LS, Abashidze EA, et al. On the development of cardiovascular diseases in children with sleep disorders. Current Pediatrics. 2015;14(6):638–644. (In Russ.) Doi: 10.15690/vsp.v14i6.1471.

41. Andrianova YeV, Samaganova AN, Akhmadeeva LR. Sleep and autonomic nervous system reactions. Effective Pharmacotherapy. 2024;20(27):16–21. (In Russ.) Doi: 10.33978/2307-3586-2024-20-27-16-21.

42. Garbarino S, Lanteri P, Bragazzi NL, et al. Role of sleep deprivation in immune-related disease risk and outcomes. Communications Biology. 2021;4:1304. Doi: 10.1038/s42003-021-02825-4.

43. Shilov AV, Mnikhovich MV, Kalinin RE, et al. Morphological changes in the wall of vessels in endothelial dysfunction. Journal of Anatomy and Histopathology. 2017;6(2):115–121. (In Russ.) Doi: 10.18499/2225-7357-2017-6-2-115-121.

44. Vlasov TD, Nesterovich II, Shimanski DA. Endothelial dysfunction: from the particular to the general. Return to the «Old Paradigm»? Regional blood circulation and microcirculation. 2019;18(2):19–27. (In Russ.) Doi: 10.24884/1682-6655-2019-18-2-19-27.

45. Vlasova TI, Petrishchev NN, Vlasov TD. Endothelial dysfunction as the typical pathological state. Regional blood circulation and microcirculation. 2022;21(2):4–15. (In Russ.) Doi: 10.24884/1682-6655-2022-21-2-4-15.

46. Cherubini JM, Cheng JL, Williams JS, MacDonald MJ. Sleep deprivation and endothelial function: reconciling seminal evidence with recent perspectives. Am J Physiol Heart Circ Physiol. 2021;320(1):H29–H35. Doi: 10.1152/ajpheart.00607.2020.

47. Rodionov RN, Blokhin IO, Galagudza MM, et al. The emerging role of asymmetric dimethylarginine in cardiovascular disease. Arterial Hypertension. 2008;14(4):306–314. (In Russ.) Doi: 10.18705/1607-419X-2008-14-4-306-314.

48. Aribas A, Kayrak M, Tekinalp M, et al. The relationship between serum asymmetric dimethylarginine levels and subjective sleep quality in normotensive patients with type 2 diabetes mellitus. Korean J Intern Med. 2015;30(3):316–324. Doi: 10.3904/kjim.2015.30.3.316.

49. Petrishchev NN, Vasina LV. Disorders of adhesive activity as a form of endothelial dysfunction. Translational Medicine. 2014;(3):5–15. (In Russ.) Doi: 10.18705/2311-4495-2014-0-3-5-15.

50. Vasina LV, Petrishchev NN, Vlasov TD. Markers of endothelial dysfunction. Regional blood circulation and microcirculation. 2017;16(1):4–15. (In Russ.) Doi: 10.24884/1682-6655-2017-16-1-4-15.

51. Smith AH, Schnyders J, Birckbichler M, et al. Sleep and endothelial dysfunction: the effects of obstructive sleep apnea and sleep deprivation. Sleep. 2018;41(1):A324. Doi: 10.1093/sleep/zsy061.870.

52. Solarz DE, Mullington JM, Meier-Ewert HK. Sleep, inflammation and cardiovascular disease. Front Biosci (Elite Ed). 2012;4(7):2490–2501. Doi: 10.2741/e560.

53. Grandner MA, Sands-Lincoln MR, Pak VM, Garland SN. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nat Sci Sleep. 2013;5:93–107. Doi: 10.2147/NSS.S31063.

54. Tobaldini E, Fiorelli EM, Solbiati M, et al. Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence. Nat Rev Cardiol. 2019;16(4):213–224. Doi: 10.1038/s41569-018-0109-6.

55. Beaman A, Bhide MC, McHill AW, Thosar SS. Biological pathways underlying the association between habitual long-sleep and elevated cardiovascular risk in adults. Sleep Med. 2021;78:135–140. Doi: 10.1016/j.sleep.2020.12.011.

56. Sang D, Lin K, Yang Y, et al. Prolonged sleep deprivation induces a cytokine-storm-like syndrome in mammals. Cell. 2023;186(25):5500–5516.e21. Doi: 10.1016/j.cell.2023.10.025.

57. Flemming A. Sleep deprivation whips up cytokine storm. Nat Rev Immunol. 2024;24(1):2. Doi: 10.1038/s41577-023-00980-9.

58. Zimmermann O, Li K, Zaczkiewicz M, et al. C-reactive protein in human atherogenesis: facts and fiction. Mediators Inflamm. 2014;2014:561428. Doi: 10.1155/2014/561428.

59. Rico-Rosillo MG, Vega-Robledo GB. Sueño y sistema immune [Sleep and immune system]. Rev Alerg Mex. 2018;65(2):160–170. Doi: 10.29262/ram.v65i2.359.

60. Betteridge DJ. What is oxidative stress? Metabolism. 2000;49(2 Suppl 1):3–8. Doi: 10.1016/s0026-0495(00)80077-3.

61. Pozhilova EV, Novikov VE, Levchenkova OS. Reactive oxygen species in cell physiology and pathology. Vestnik Smolenskoj gosudarstvennoj medicinskoj akademii. 2015;(2):13–22. (In Russ.)

62. Hajam YA, Rani R, Ganie SY, et al. Oxidative stress in human pathology and aging: molecular mechanisms and perspectives. Cells. 2022;11(3):552. Doi: 10.3390/cells11030552.

63. Periasamy S, Hsu DZ, Fu YH, Liu MY. Sleep deprivation-induced multi-organ injury: role of oxidative stress and inflammation. EXCLI J. 2015;14:672–683. Doi: 10.17179/excli2015-245.

64. Atrooz F, Salim S. Sleep deprivation, oxidative stress and inflammation. Adv Protein Chem Struct Biol. 2020;119:309–336. Doi: 10.1016/bs.apcsb.2019.03.001.

65. Neculicioiu VS, Colosi IA, Costache C, et al. Sleep deprivation-induced oxidative stress in rat models : a scoping systematic review. Antioxidants (Basel). 2023;12(8):1600. Doi: 10.3390/antiox12081600.

66. Shah R, Shah VK, Emin M, et al. Mild sleep restriction increases endothelial oxidative stress in female persons. Sci Rep. 2023;13(1):15360. Doi: 10.1038/s41598-023-42758-y.

67. Davinelli S, Medoro A, Savino R, Scapagnini G. Sleep and oxidative stress: current perspectives on the role of NRF2. Cell Mol Neurobiol. 2024;44(1):52. Doi: 10.1007/s10571-024-01487-0.

68. Sauvet F, Florence G, Van Beers P, et al. Total sleep deprivation alters endothelial function in rats: a nonsympathetic mechanism. Sleep. 2014;37(3):465–473. Doi: 10.5665/sleep.3476.

69. Nawi A, Eu KL, Faris ANA, et al. Lipid peroxidation in the descending thoracic aorta of rats deprived of REM sleep using the inverted flowerpot technique. Exp Physiol. 2020; 105(8):1223–1231. Doi: 10.1113/EP088667.

70. Zhu Y, Chen X, Guo L, et al. Acute sleep deprivation increases inflammation and aggravates heart failure after myocardial infarction. J Sleep Res. 2022;31(6):e13679. Doi: 10.1111/jsr.13679.

71. Jiang J, Gan Z, Li Y, et al. REM sleep deprivation induces endothelial dysfunction and hypertension in middle-aged rats: Roles of the eNOS/NO/cGMP pathway and supplementation with L-arginine. PLoS One. 2017;12(8):e0182746. Doi: 10.1371/journal.pone.0182746.

72. Liu SH, Lin FJ, Kao YH, et al. Chronic partial sleep deprivation increased the incidence of atrial fibrillation by promoting pulmonary vein and atrial arrhythmogenesis in a rodent model. Int J Mol Sci. 2024;25(14):7619. Doi: 10.3390/ijms25147619.

73. Kuetting DLR, Feisst A, Sprinkart AM, et al. Effects of a 24-hr-shift-related short-term sleep deprivation on cardiac function: a cardiac magnetic resonance-based study. J Sleep Res. 2019;28(3):e12665. Doi: 10.1111/jsr.12665.

74. Cherubini JM, Cheng JL, Armstrong CM, et al. Acute partial sleep restriction does not impact arterial function in young and healthy humans. Exp Physiol. 2024;109(9):1492–1504. Doi: 10.1113/EP091699.

75. Calvin AD, Covassin N, Kremers WK, et al. Experimental sleep restriction causes endothelial dysfunction in healthy humans. J Am Heart Assoc. 2014;3(6):e001143. Doi: 10.1161/JAHA.114.001143.

76. Bain AR, Weil BR, Diehl KJ, et al. Insufficient sleep is associated with impaired nitric oxide-mediated endotheliumdependent vasodilation. Atherosclerosis. 2017;265:41–46. Doi: 10.1016/j.atherosclerosis.2017.08.001.

77. Domínguez F, Fuster V, Fernández-Alvira JM, et al. Association of Sleep Duration and Quality With Subclinical Atherosclerosis. J Am Coll Cardiol. 2019;73(2):134–144. Doi: 10.1016/j.jacc.2018.10.060.

78. Yang H, Baltzis D, Bhatt V, et al. Macro- and microvascular reactivity during repetitive exposure to shortened sleep: sex differences. Sleep. 2021;44(5):zsaa257. Doi: 10.1093/sleep/zsaa257.

79. Stockelman KA, Bain AR, Goulding A, et al. Negative influence of insufficient sleep on endothelial vasodilator and fibrinolytic function in hypertensive adults. Hypertension. 2021;78(6):1829–1840. Doi: 10.1161/HYPERTENSIONAHA.121.17781.

80. Covassin N, Bukartyk J, Singh P, et al. Effects of experimental sleep restriction on ambulatory and sleep blood pressure in healthy young adults: a randomized crossover study. Hypertension. 2021;78(3):859–870. Doi: 10.1161/HYPERTENSIONAHA.121.17622.

81. Shah R, St-Onge MP, Emin M, et al. Sleep deprivation impairs vascular function in healthy women: a clinical trial. Ann Am Thorac Soc. 2022;19(12):2097–2100. Doi: 10.1513/AnnalsATS.202205-406RL.

82. DeMartino T, Ghoul RE, Wang L, et al. Oxidative stress and inflammation differentially elevated in objective versus habitual subjective reduced sleep duration in obstructive sleep apnea. Sleep. 2016;39(7):1361–1369. Doi: 10.5665/sleep.5964.

83. Xu B, Ma L, Zhang N, et al. Increased microparticle levels in middle-aged and elderly patients with insomnia may be involved in the pathogenesis of arteriosclerosis. Int Angiol. 2020;39(3):252–260. Doi: 10.23736/S0392-9590.19.04261-5.