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There's more to staying heart-healthy than just eating right and exercising regularly, namely getting enough shuteye.

Indeed, sleep plays an important role in overall health and well-being. By the same token, healthy diet, regular exercise and low stress may promote the sort of deep, restorative sleep that is essential for good cardiovascular health.

How much sleep do you need? The Centers for Disease Control and Prevention in Atlanta advises adults between 18 and 65 to aim for at least seven hours of good quality sleep per night.

Unfortunately, sleeping well is not the necessarily the norm. In fact, according to the National Heart, Lung, and Blood Institute of the National Institutes of Health, 50 million to 70 million American adults either don't get any sleep on a regular basis or have a sleeping disorder.

How does sleep affect heart health?

Studies show short sleep duration or poor sleep quality, is associated with high blood pressure, elevated cholesterol and atherosclerosis. And habitual short sleep increases the chance of cardiovascular events.

Not getting enough restful sleep is also correlated with:

Poor diet / weight gain
A study of 495 participants found an association between poor sleep quality, increased food intake and lower consumption of whole grains. And short sleep duration may lead to weight gain, even in those with a low risk for obesity.

Diabetes
An analysis of past studies suggests not getting enough Z's significantly increases the risk of developing Type 2 diabetes. In addition, losing as little as two hours of sleep per day may lead to increased insulin resistance and decreased glucose tolerance in lab conditions.

High blood sugar associated with diabetes can also increase cholesterol, blood pressure and triglycerides, ultimately damaging the nerves and blood vessels. As a result, people with Type 2 diabetes are twice as likely to have a heart attack or stroke.

Inflammation
In lab studies, sleep restriction is associated with inflammation, and preliminary research suggests this may be true in the general population. This is important because inflammatory processes can elevate risk for cardiovascular disease.

Stroke, heart attack and death
Researchers report a modest link between both short and long sleep duration, or nine hours or more at a time, and stroke. Short and long duration sleep are also associated with a greater risk of death.

The link between sleeping disorders and heart disease

Perhaps unsurprisingly, a growing body of research demonstrates a correlation between many sleeping disorders and cardiovascular health.

People with common sleeping disorders such as obstructive sleep apnea or insomnia also are far more likely to have heart arrhythmias, plaque buildup, heart failure and coronary artery disease than the general public.
Evidence is mounting that neurological sleep disorders such as restless leg syndrome, which affects 7% to 10% of Americans, may increase the risk of heart disease, although more research is needed to better understand the connection.
In most people, blood pressure dips during sleep. However, that doesn't always happen in people with Type 1 narcolepsy. Although more research is needed in this area, some suggest that this may increase the risk for heart problems.

The role of mental health

There's a similar both-ways relationship between sleep and mental health: People with psychological disorders are more likely to develop sleep problems than those in the general population, and sleep problems may also increase the risk of developing certain mental illnesses.

This may affect heart health. Many studies have shown both daily stressors and traumatic stressful events increase the risk of cardiovascular disease. Loneliness, workplace stress, anger and hostility, anxiety, depression and even pessimism likewise impact overall health, increasing the risk to heart health.

Optimism, on the other hand, is associated with healthier living, including better sleep quality and a lower risk of cardiovascular disease and death from all causes.

In a recent scientific statement, the American Heart Association acknowledged the growing body of evidence pointing to the strong link between mental health, behaviors and physical health, noting data that suggest treating mental health can improve heart health.

What's the takeaway?

There's a strong connection between mental health, sleep and overall physical health, specifically cardiovascular health.

Lifestyle factors such as diet and exercise may reduce the risk of heart disease, both directly and indirectly, by fostering better sleep. This, in turn, may lead to a better outlook and more energy – the very best kind of feedback loop.

What should I do if I have problems sleeping?

The CDC advises people to:

Go to bed and wake up at the same time every day, weekends included.
Sleep in a dark, quiet place set at a comfortable temperature.
Ban electronic devices from the bedroom. These can interfere with sleep.
Avoid caffeine, alcohol and large meals before hitting the pillow.
Exercise. Physical activity during the day makes it easier to fall asleep that night.

Talk with your doctor or health care professional if you have symptoms of a sleep disorder or have tried such measures and still can't get to sleep.

Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.