{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:16:11Z","timestamp":1791818171519,"version":"4.3.4"},"reference-count":129,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Sleep regularity is an essential part of the multidimensional sleep health framework. The phenomenon of irregular sleep patterns is widespread in contemporary lifestyles. This review synthesizes clinical evidence to summarize the measures of sleep regularity and discusses the role of different sleep regularity indicators in developing cardiometabolic diseases (coronary heart disease, hypertension, obesity, and diabetes). Existing literature has proposed several measurements to assess sleep regularity, mainly including the standard deviation (SD) of sleep duration and timing, sleep regularity index (SRI), interdaily stability (IS), and social jetlag (SJL). Evidence on associations between sleep variability and cardiometabolic diseases varies depending on the measure used to characterize variability in sleep. Current studies have identified a robust association between SRI and cardiometabolic diseases. In comparison, the association between other metrics of sleep regularity and cardiometabolic diseases was mixed. Meanwhile, the associations of sleep variability with cardiometabolic diseases differ across the population. SD of sleep characteristics or IS may be more consistently associated with HbA1c in patients with diabetes compared with the general population. The association between SJL and hypertension for patients with diabetes was more accordant than in the general population. Interestingly, the age-stratified association between SJL and metabolic factors was observed in the present studies. Furthermore, the relevant literature was reviewed to generalize the potential mechanisms through which irregular sleep increases cardiometabolic risk, including circadian dysfunction, inflammation, autonomic dysfunction, hypothalamic\u2013pituitary\u2013adrenal (HPA) axis disorder, and gut dysbiosis. Health-related practitioners should give more attention to the role of sleep regularity on human cardiometabolic in the future.<\/jats:p>","DOI":"10.3389\/fcvm.2023.1059257","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T04:53:11Z","timestamp":1676609591000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":35,"title":["Irregular sleep and cardiometabolic risk: Clinical evidence and mechanisms"],"prefix":"10.3389","volume":"10","author":[{"given":"Chengjie","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"109","DOI":"10.5664\/jcsm.6894","article-title":"Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults","volume":"14","author":"Lao","year":"2018","journal-title":"J Clin Sleep Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"489","DOI":"10.5664\/jcsm.7684","article-title":"Sleep disturbances in patients with coronary heart disease: a systematic review","volume":"15","author":"Madsen","year":"2019","journal-title":"J Clin Sleep Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1093\/eurheartj\/ehr007","article-title":"Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies","volume":"32","author":"Cappuccio","year":"2011","journal-title":"Eur Heart J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1093\/ehjdh\/ztab088","article-title":"Accelerometer-derived sleep onset timing and cardiovascular disease incidence: a Uk biobank cohort study","volume":"2","author":"Nikbakhtian","year":"2021","journal-title":"Euro Heart J Digital Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1097\/01.psy.0000244071.42939.0e","article-title":"Diurnal cortisol decline is related to coronary calcification: cardia study","volume":"68","author":"Matthews","year":"2006","journal-title":"Psychosom Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3216","DOI":"10.1038\/s41598-017-03171-4","article-title":"Irregular sleep\/wake patterns are associated with poorer academic performance and delayed circadian and sleep\/wake timing","volume":"7","author":"Phillips","year":"2017","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s11892-020-01324-w","article-title":"Sleep regularity and cardiometabolic heath: is variability in sleep patterns a risk factor for excess adiposity and glycemic dysregulation?","volume":"20","author":"Zuraikat","year":"2020","journal-title":"Curr Diab Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"235","DOI":"10.2337\/dc19-0550","article-title":"Sleep and Hba1c in patients with type 2 diabetes: which sleep characteristics matter Most?","volume":"43","author":"Brouwer","year":"2020","journal-title":"Diabetes Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"zsaa175","DOI":"10.1093\/sleep\/zsaa175","article-title":"Sleep duration regularity, but not sleep duration, is associated with microvascular function in college students","volume":"44","author":"Hoopes","year":"2021","journal-title":"Sleep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"k4641","DOI":"10.1136\/bmj.k4641","article-title":"Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large us cohorts of female nurses","volume":"363","author":"Shan","year":"2018","journal-title":"BMJ"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"229","DOI":"10.5271\/sjweh.3700","article-title":"Shift work and the risk of cardiovascular disease. 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