Sleep duration, sleep continuity, and depression are associated with cardiovascular
disease and metabolic disorders. Despite the well-established relationship between
sleep and depression, few studies examine these characteristics simultaneously in
the development of cardiometabolic disease. Here, we review available studies that
include measures of both sleep and depression in relation to cardiometabolic outcomes
(cardiovascular disease, diabetes, and the metabolic syndrome). In general, data show
that independent of depression, sleep continuity is a risk factor for cardiovascular
disease, and short or long sleep duration is a risk factor for diabetes and the metabolic
syndrome. Results for associations between sleep duration and cardiovascular disease,
and associations between sleep continuity and metabolic disease, are more mixed. Regarding
depression, there is preliminary evidence that depression increases risk for cardiovascular
disease, independent of sleep continuity. However, there are insufficient data to
address whether relationships between depression and cardiovascular and metabolic
disease are independent of sleep duration. A number of biobehavioral mechanisms, including
inflammation, hypothalamic and sympathetic dysregulation, and obesity and health behaviors,
may account for the relationships among sleep, depression, and cardiometabolic disease.
After summarizing these mechanisms, we discuss limitations of the extant literature
and suggest directions for future research.
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