Cardiology has made extraordinary progress in imaging, prevention and risk stratification and advanced therapeutics, yet one clinically significant determinant of cardiovascular health remains structurally absent from our training pathways: sleep. The science connecting sleep physiology to cardiovascular disease is robust and actionable, but cardiologists are not equipped with the practical mechanisms to use it. This gap is no longer sustainable for a discipline that defines itself by evidence-based care.
Sleep disorders materially change cardiovascular trajectories
Sleep apnea, insomnia, restless leg syndrome, narcolepsy and other sleep-related disorders exert notable influence on elevated blood pressure, arrhythmia vulnerability and metabolic dysregulation. These effects are not peripheral. They shape hypertension, atrial fibrillation, heart failure progression, stroke risk and overall cardiovascular disease (CVD) risk.1
A recent study found that a prior diagnosis of sleep disorders was associated with a nearly 1.22-fold higher chance of developing heart failure.2 Moreover, research shows that adults with obstructive sleep apnea (OSA) have worse CVD-related outcomes and patients with insomnia have a 31% increased incidence of cardiovascular disease.3,4
Major medical organizations have already signaled that action is needed. The American Heart Association already calls for OSA screening in key CVD populations, includes appropriate sleep in the Life’s Essential 85 and recommends formal evaluation when heart failure patients show signs of sleep-disordered breathing.6
A cardiology-focused sleep certification is the logical next step
Cardiology needs a dedicated, credible pathway that teaches clinicians and care teams the sleep competencies most relevant to cardiovascular health. If designed around common clinical scenarios, cardiac comorbidities and realistic diagnostic and management workflows, this certification would make sleep medicine a natural, expected dimension of cardiology rather than a niche interest or referral afterthought.
Such a certification would not replace sleep medicine. It would complement it by focusing on the disorders, diagnostic tools and management decisions that intersect directly with cardiovascular outcomes.
A well-designed certification would:
- Define core sleep competencies mapped to common cardiac conditions and care pathways.
- Offer modular, practical education adaptable to fellowship training and ongoing continuing medical education (CME).
- Provide assessment and recognition mechanisms trusted by societies, payers and health systems.
The goal is not to create hybrid sleep–cardiology specialists per se. It is to accelerate the shift from isolated champions to system-level adoption of sleep-informed care. Ultimately, it will help cement sleep assessment and management as part of the cardiology standard of care and may shape how future guidelines are written and how clinical networks operate.
A practical precedent: How obesity medicine created a cross-specialty certification
The creation of the American Board of Obesity Medicine (ABOM) certification is a relevant precedent. Obesity affects nearly every major chronic disease pathway, yet for decades it sat at the margins of clinical training.
Clinicians acknowledged its impact on outcomes, but no specialty owned the domain and therefore, no formal mechanism to ensure consistent, evidence-based competence existed. The eventual solution was a focused, cross-disciplinary certification designed to equip clinicians from multiple fields with knowledge they could apply within their scope of practice.
Today, ABOM certification is open to physicians from internal medicine, family medicine, cardiology, endocrinology, pediatrics, OB-GYN and others.7 It provides structured requirements, a curriculum grounded in current science and a standardized exam.
The ABOM certification ensures that clinicians who routinely manage the consequences and comorbidities of obesity can do so with an elevated, credible level of training. This is the nature of model a cardiology-sleep certification can emulate and build on.
Why now?
The longer sleep continues to sit outside cardiology’s formal structure, we will keep missing opportunities to improve outcomes. We will keep reacting to sleep issues instead of integrating their identification upstream. And we will keep telling patients that healthy sleep is important while giving clinicians no clear mechanism to act on it.
A dedicated certification changes that. It equips cardiology with a credible, consistent and clinically relevant framework. It also aligns with the direction of medicine: toward whole-person care, personalization and recognition of chronic drivers that shape overall health.
A collective responsibility for the field
Creating a cardiology-focused sleep certification will require collaboration across medical boards, guideline committees, CME bodies, fellowship directors and sleep medicine leaders. But the alternative is to continue operating below the level of evidence.
Cardiology has always aligned itself with scientific rigor and clinical completeness. A dedicated sleep certification is the next step in that tradition, and an essential one if we are serious about improving patient outcomes.
