Dynamic coupling between the central and autonomic nervous systems during sleep: a review
Open accessAbstract
Sleep is characterized by coordinated cortical and cardiac oscillations reflecting communication between the central (CNS) and autonomic (ANS) nervous systems. Here, we review fluctuations in ANS activity in association with CNS-defined sleep stages and cycles, and with phasic cortical events during sleep (e.g., arousals, K-complexes). Recent novel analytic methods reveal a dynamic organization of integrated physiological networks during sleep and indicate how multiple factors (e.g., sleep structure, age, sleep disorders) affect "CNS-ANS coupling". However, these data are mostly correlational and there is a lack of clarity of the underlying physiology, making it challenging to interpret causality and direction of coupling. Experimental manipulations (e.g., evoking K-complexes or arousals) provide information on the precise temporal sequence of cortical-cardiac activity, and are useful for investigating physiological pathways underlying CNS-ANS coupling. With the emergence of new analytical approaches and a renewed interest in ANS and CNS communication during sleep, future work may reveal novel insights into sleep and cardiovascular interactions during health and disease, in which coupling could be adversely impacted.
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Close bidirectional coupling between sleep states and the autonomic nervous system is suggested by the marked increase in parasympathetic outflow during NREM, especially SWS.
“Close, bidirectional coupling between sleep states and the autonomic nervous system is suggested by the marked increase in parasympathetic outflow during NREM, especially its deepest stage, SWS (de Zambotti et al., 2018).”
From Physiological feelings (2019) · cites this paper as de Zambotti et al., 2018
Section 2 (page unavailable) says HRV suggests stronger vagal modulation during NREM sleep. Section 1.2 (page unavailable) describes both efferent and afferent pathways underlying CNS–ANS coupling. The review does not establish a marked increase in parasympathetic outflow specifically during SWS; its N3 finding concerns baroreflex coupling, not parasympathetic outflow. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA review by de Zambotti et al. (2018) showed that CNS and ANS measures couple during sleep, so that brain oscillatory activity parallels fluctuations in cardiac activity.
“A review of the literature by de Zambotti et al. (2018), for example, showed that CNS and ANS measures couple during sleep, so that brain oscillatory activity parallels fluctuations in cardiac activity.”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as de Zambotti et al. (2018)
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Wearable Sleep Technology in Clinical and Research Settings
DE ZAMBOTTI, M., CELLINI, N., GOLDSTONE, A., COLRAIN, I. M., & BAKER, F. C. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001947 · Cited by 564 · see citing works
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- Authors
- de Zambotti, M., Trinder, J., Silvani, A., Colrain, I. M., & Baker, F. C.
- Affiliations
- The University of Melbourne (AU)
- University of Bologna (IT)
- SRI International (US)
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 90
- Pages
- 84-103
- ISSN
- 0149-7634 (ISSN-L)
- PMC
- PMC5993613
- OpenAlex
- W2799328995
- Cited by
- 194
- References
- 180
- Citations by year
- 2026: 18 · 2025: 29 · 2024: 19 · 2023: 28 · 2022: 23 · 2021: 33 · 2020: 19 · 2019: 21 · 2018: 4
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, other-oa)
- Funders
- National Institutes of Health (HL103688, AA021696, AA020565, AA024841)
- National Health and Medical Research Council (1027076)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- autonomic nervous system, central nervous system, sleep, sleep stages, sleep cycles, cortical oscillations, cardiac oscillations, K-complexes, sleep arousal, sleep architecture, sleep disorders, age effects
- MeSH terms
- Autonomic Nervous System, Cardiovascular Physiological Phenomena, Heart Rate, Humans, Sleep, Sleep Wake Disorders, Sleep Stages
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