One night on-call: Sleep deprivation affects cardiac autonomic control and inflammation in physicians
Abstract
Background Sleep loss is associated with increased cardiovascular morbidity and mortality. It is known that chronic sleep restriction affects autonomic cardiovascular control and inflammatory response. However, scanty data are available on the effects of acute sleep deprivation (ASD) due to night shifts on the cardiovascular system and its capability to respond to stressor stimuli. The aim of our study was to investigate whether a real life model of ASD, such as "one night on-call", might alter the autonomic dynamic response to orthostatic challenge and modify the immune response in young physicians.Methods Fifteen healthy residents in Internal Medicine were studied before and after one night on-call at Rest and during a gravitational stimulus (head up-tilt test, HUT). Heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were analyzed during Rest and HUT before and after ASD. Plasmatic hormones (epinephrine, norepinephrine, cortisol, renin, aldosterone, ACTH) and tissue inflammatory cytokines were measured at baseline and after ASD.Result HRV analysis revealed a predominant sympathetic modulation and a parasympathetic withdrawal after ASD. During HUT, the sympathovagal balance shifted towards a sympathetic predominance before and after ASD. However, the magnitude of the autonomic response was lower after ASD. BPV and BRS remained unchanged before and after ASD as the hormone levels, while IFN-γ increased after ASD compared to baseline.Conclusion In summary, one night of sleep deprivation, at least in this real-life model, seems to affect cardiovascular autonomic response and immune modulation, independently by the activation of the hypothalamic-pituitary axis.
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Altered sleep has been observed in rats and mice following dietary supplementation of commensals.
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Total sleep deprivation of more than 24 hours or partial deprivation of 3-4 hours in bed each night for 1-3 days showed no significant change in morning cortisol levels after sleep deprivation.
“Total sleep deprivation of more than 24 hours [79–81] or partial deprivation of 3–4 hours in bed each night for 1–3 days [34, 44, 82] showed no significant change in morning cortisol levels after sleep deprivation.”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [80]
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- Authors
- Tobaldini, E., Cogliati, C., Fiorelli, E. M., Nunziata, V., Wu, M. A., Prado, M., Bevilacqua, M., Trabattoni, D., Porta, A., & Montano, N.
- Affiliations
- University of Milan (IT)
- Luigi Sacco Hospital (IT)
- Corresponding author
- Montano, Nicola
- ORCID
- Venue
- European Journal of Internal Medicine
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 24
- Issue
- 7
- Pages
- 664-670
- ISSN
- 0953-6205 (ISSN-L)
- OpenAlex
- W2004911664
- Semantic Scholar
- 67cb7726663cf6cb3d989d8cb7daaeea1bb9d6c7
- Cited by
- 127
- References
- 50
- Citations by year
- 2026: 2 · 2025: 12 · 2024: 7 · 2023: 11 · 2022: 12 · 2021: 14 · 2020: 9 · 2019: 12 · 2018: 9 · 2017: 10 · 2016: 6 · 2015: 14 · 2014: 7 · 2013: 2
- FWCI
- 13.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- acute sleep deprivation, night shift work, cardiac autonomic control, inflammation, heart rate variability, baroreflex sensitivity, blood pressure variability, sympathovagal balance, hypothalamic-pituitary axis, cytokines, interferon-gamma, physicians, internal medicine residents, orthostatic challenge
- MeSH terms
- Adult, Autonomic Nervous System, Blood Pressure, Female, Heart Rate, Hormones, Humans, Inflammation, Male, Medical Staff, Hospital, Night Care, Personnel Staffing and Scheduling, Sleep Deprivation, Work Schedule Tolerance, Biomarkers, Baroreflex
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