<![CDATA[Preeclampsia remains one of the leading causes of maternal and neonatal mortality worldwide, yet its underlying mechanisms continue to be investigated. Sleep disturbances during pregnancy are highly prevalent but frequently overlooked in clinical practice. This systematic review aimed to synthesize scientific evidence regarding the relationship between sleep disturbances, endothelial dysfunction, and preeclampsia in pregnancy. Literature searches were conducted through PubMed and Google Scholar, covering publications from 2022 to 2026, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. From 2542 initially identified articles, six met all inclusion criteria and were analyzed using descriptive narrative synthesis. Findings consistently demonstrated that various forms of sleep disturbances are associated with elevated markers of vascular damage and increased risk of preeclampsia. Endothelial dysfunction served as the primary biological pathway linking both conditions, operating through mechanisms of inflammation, oxidative stress, and impaired vascular reactivity. Sleep disturbances occurring as early as the first trimester were identified as significant predictors of subsequent preeclampsia. These findings suggest that sleep quality during pregnancy should be recognized as a modifiable risk factor and incorporated into routine antenatal care.]]>
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