These two sleep disorders together may triple heart disease risk: Study

A massive study of nearly one million US veterans finds that having both insomnia and sleep apnea sharply raises the risk of hypertension and cardiovascular disease

A new study has found that people who suffer from both insomnia and obstructive sleep apnea face a significantly higher risk of developing high blood pressure and cardiovascular disease than those with only one sleep disorder.

 

Researchers from Yale School of Medicine analysed health data from nearly one million post-9/11 US veterans and found that the overlap of the two conditions, known as comorbid insomnia and sleep apnea (COMISA), was linked to a significantly increased risk of high blood pressure and cardiovascular disease.

 

The study titled Insomnia, Sleep Apnea, and Incidence of Hypertension and Cardiovascular Disease Among Men and Women US Veterans, published in the Journal of the American Heart Association, highlights sleep problems as a powerful yet often overlooked factor in heart health.

 

What did the study find about insomnia, sleep apnea, and heart risk?

The research followed 937,598 veterans receiving care in the US Veterans Health Administration over roughly two decades. The median age of participants was 41 years, and about 12 per cent were women.

 

The results showed that compared with people without sleep disorders those with both insomnia and sleep apnea had

• more than double the risk of developing hypertension
• over three times the risk of cardiovascular disease

The researchers also found that even when insomnia or sleep apnea occurred alone, each was linked to increased cardiovascular risk.

 

The study also analysed results separately for men and women and found that the combined sleep disorder increased risk in both sexes.

What is COMISA and why do doctors consider it risky?

Doctors refer to the overlap of insomnia and obstructive sleep apnea as COMISA (comorbid insomnia and sleep apnea).

 

Insomnia involves persistent difficulty falling asleep or staying asleep.

 

Obstructive sleep apnea (OSA) causes repeated pauses in breathing during sleep due to airway blockage.

 

Although these disorders are often treated separately, many people experience both at the same time. In the study population, about 14 per cent of veterans had COMISA, while 13 per cent had insomnia alone and about 21 per cent had sleep apnea alone.

 

Researchers say treating only one disorder while ignoring the other may leave a major health risk unresolved.

Why can sleep disorders increase heart disease risk?

The study authors stressed that sleep is a vital maintenance period for the cardiovascular system.

 

When sleep is fragmented or repeatedly interrupted:

• Blood pressure remains elevated overnight
• Stress hormones rise
• Inflammation increases
• The heart and blood vessels lose time to recover

According to the study, these disruptions may lead to autonomic dysfunction, vascular damage, and increased strain on the heart, eventually contributing to conditions such as hypertension, heart failure, stroke, or heart attack.

 

The overlap of insomnia and sleep apnea likely amplifies these harmful processes, explaining the stronger cardiovascular risk observed.

Can treating sleep disorders reduce heart disease risk?

Researchers say the findings highlight an important opportunity for prevention. Sleep disturbances are:

• Common
• Detectable through screening
• Treatable with medical and behavioural interventions

For instance, continuous positive airway pressure (CPAP) therapy helps manage sleep apnea, while cognitive behavioural therapy for insomnia (CBT-I) can improve chronic insomnia. Combining these approaches may be particularly helpful for people with COMISA.

 

The researchers stressed that doctors should pay more attention to sleep. Traditionally, cardiovascular care has focused on well-known risk factors such as cholesterol, smoking, and obesity. The study suggests sleep disorders deserve a place alongside those risks in routine health checks. Identifying and treating insomnia and sleep apnea early could help reduce the long-term burden of heart disease. 

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This content is for informational purposes only and is not a substitute for professional medical advice.