Having both insomnia and sleep apnea may significantly raise the risk of heart disease and high blood pressure.
Researchers analyzed health data from nearly one million U.S. veterans to understand the connection.
Treating overlapping sleep disorders — not just one — could play a role in reducing long-term risk.
Sleep is often treated as a side issue when it comes to overall health — but new research suggests it may play a much bigger role in heart health than many people realize.
According to a recent study highlighted by Yale School of Medicine, sleep disorders like insomnia and obstructive sleep apnea aren’t just frustrating — they may also be important, and potentially modifiable, risk factors for cardiovascular disease.
“We spend an enormous amount of time managing cardiovascular disease downstream, but far less time addressing more upstream modifiable risk factors,” researcher Allison Gaffey, Ph.D., said in a news release.
“Sleep disturbances, which are common in the veteran population, are often treated as secondary problems.”
The study
To better understand this connection, researchers analyzed health data from nearly one million post-9/11 U.S. veterans. This large-scale study, published in the Journal of the American Heart Association, focused on identifying how insomnia, sleep apnea, and the combination of both (known as comorbid insomnia and sleep apnea, or COMISA) relate to cardiovascular outcomes.
Participants’ medical records were used to track diagnoses of insomnia and obstructive sleep apnea, along with the development of conditions like hypertension and cardiovascular disease over time.
By comparing groups — those with insomnia alone, sleep apnea alone, both conditions, or neither — researchers were able to isolate how each scenario influenced risk.
This approach allowed the team to look beyond individual sleep disorders and instead examine how overlapping conditions may create a distinct risk profile.
What the researchers found
The results point to a clear pattern: people with both insomnia and sleep apnea faced the highest risks. Compared to those without these conditions, individuals with COMISA had more than double the risk of developing hypertension and more than triple the risk of cardiovascular disease.
Importantly, the increased risk was consistent across both men and women, suggesting the findings may apply broadly within similar populations.
Researchers emphasize that this combination of sleep disorders represents a distinct and particularly harmful state — not just the sum of two separate issues. Addressing one condition while overlooking the other may leave underlying risks unresolved.
“These conditions don’t just coexist politely,” Dr. Gaffey said. “Treating one while ignoring the other is a bit like bailing water out of a boat without fixing the leak.”
Taken together, the findings highlight sleep as more than just a lifestyle factor — it may be an important piece of the cardiovascular health puzzle, especially when multiple sleep issues overlap.