“Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review

Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy or “broken heart syndrome”, is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. Emerging evidence suggests that sleep-disordered breathing (SDB) and sleep disruption may pla...

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Main Authors: Ioannis Alevroudis, Magda Petridou, Agni Sakkou, Serafeim-Chrysovalantis Kotoulas, Sotirios Matzolas, Panagiotis Roumelis, Maria Stougianni, Eleni Massa, Eleni Mouloudi
Format: Article
Language:English
Published: IMR Press 2025-05-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM28244
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author Ioannis Alevroudis
Magda Petridou
Agni Sakkou
Serafeim-Chrysovalantis Kotoulas
Sotirios Matzolas
Panagiotis Roumelis
Maria Stougianni
Eleni Massa
Eleni Mouloudi
author_facet Ioannis Alevroudis
Magda Petridou
Agni Sakkou
Serafeim-Chrysovalantis Kotoulas
Sotirios Matzolas
Panagiotis Roumelis
Maria Stougianni
Eleni Massa
Eleni Mouloudi
author_sort Ioannis Alevroudis
collection DOAJ
description Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy or “broken heart syndrome”, is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. Emerging evidence suggests that sleep-disordered breathing (SDB) and sleep disruption may play a significant role in the pathophysiology and exacerbation of TTS. This review explores the influence of conditions such as obstructive sleep apnea (OSA), insomnia, and other sleep disturbances on the onset and progression of TTS. SDB, particularly OSA, is marked by repetitive episodes of upper airway obstruction during sleep, leading to intermittent hypoxia and increased sympathetic nervous system activity. These physiological changes can trigger or exacerbate TTS by promoting myocardial stress and impairing autonomic regulation. Insomnia and other forms of sleep disruption also contribute to heightened sympathetic activity and elevated stress hormone levels, which may precipitate TTS in susceptible individuals. Thus, this review synthesizes current research on the mechanisms linking sleep disturbances to TTS, highlighting the impact of nocturnal hypoxia, sleep fragmentation, and autonomic dysregulation. Moreover, this review discusses the clinical implications of these findings, emphasizing the need to screen and manage sleep disorders in patients with or at risk of TTS. Addressing sleep disturbances through therapeutic interventions may reduce the incidence and recurrence of TTS, offering a novel approach to managing this condition. In conclusion, this review underscores the importance of recognizing and treating SDB and sleep disruption as potential contributors to Takotsubo syndrome. Future research should focus on elucidating the precise mechanisms involved and determining effective strategies for integrating sleep management into the care of patients with TTS.
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spelling doaj-art-e14cc962964a4fc0a7cc3e1882a1fa6c2025-08-20T02:03:25ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-05-012652824410.31083/RCM28244S1530-6550(25)01794-6“Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive ReviewIoannis Alevroudis0Magda Petridou1Agni Sakkou2Serafeim-Chrysovalantis Kotoulas3Sotirios Matzolas4Panagiotis Roumelis5Maria Stougianni6Eleni Massa7Eleni Mouloudi8Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceThird Department of Cardiology, General Hospital of Thessaloniki “Ippokrateio”, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceAdult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, GreeceTakotsubo syndrome (TTS), also known as stress-induced cardiomyopathy or “broken heart syndrome”, is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. Emerging evidence suggests that sleep-disordered breathing (SDB) and sleep disruption may play a significant role in the pathophysiology and exacerbation of TTS. This review explores the influence of conditions such as obstructive sleep apnea (OSA), insomnia, and other sleep disturbances on the onset and progression of TTS. SDB, particularly OSA, is marked by repetitive episodes of upper airway obstruction during sleep, leading to intermittent hypoxia and increased sympathetic nervous system activity. These physiological changes can trigger or exacerbate TTS by promoting myocardial stress and impairing autonomic regulation. Insomnia and other forms of sleep disruption also contribute to heightened sympathetic activity and elevated stress hormone levels, which may precipitate TTS in susceptible individuals. Thus, this review synthesizes current research on the mechanisms linking sleep disturbances to TTS, highlighting the impact of nocturnal hypoxia, sleep fragmentation, and autonomic dysregulation. Moreover, this review discusses the clinical implications of these findings, emphasizing the need to screen and manage sleep disorders in patients with or at risk of TTS. Addressing sleep disturbances through therapeutic interventions may reduce the incidence and recurrence of TTS, offering a novel approach to managing this condition. In conclusion, this review underscores the importance of recognizing and treating SDB and sleep disruption as potential contributors to Takotsubo syndrome. Future research should focus on elucidating the precise mechanisms involved and determining effective strategies for integrating sleep management into the care of patients with TTS.https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM28244insomniaobstructive sleep apnearestless leg syndromesleep deprivationtakotsubo syndromehypothalamic-pituitary-adrenal (hpa) axiselevated catecholamine levelsheart rate variability
spellingShingle Ioannis Alevroudis
Magda Petridou
Agni Sakkou
Serafeim-Chrysovalantis Kotoulas
Sotirios Matzolas
Panagiotis Roumelis
Maria Stougianni
Eleni Massa
Eleni Mouloudi
“Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
Reviews in Cardiovascular Medicine
insomnia
obstructive sleep apnea
restless leg syndrome
sleep deprivation
takotsubo syndrome
hypothalamic-pituitary-adrenal (hpa) axis
elevated catecholamine levels
heart rate variability
title “Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
title_full “Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
title_fullStr “Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
title_full_unstemmed “Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
title_short “Restless Nights, Stressed Hearts”: The Link Between Sleep Disorders and Takotsubo Syndrome—A Comprehensive Review
title_sort restless nights stressed hearts the link between sleep disorders and takotsubo syndrome a comprehensive review
topic insomnia
obstructive sleep apnea
restless leg syndrome
sleep deprivation
takotsubo syndrome
hypothalamic-pituitary-adrenal (hpa) axis
elevated catecholamine levels
heart rate variability
url https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM28244
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