Waking up properly: Is there a role of thermoregulation in sleep inertia?
Abstract
We assume that alertness should be highest at the end of a sleep episode: it is not. There is always sleep inertia upon awakening, which can last minutes to hours, and whose underlying physiological mechanisms are largely unknown. Previously, we had found a functional relationship between the degree of distal vasodilatation (as measured by the distal-proximal skin temperature gradient (DPG) and sleepiness (as measured by subjective ratings), promoting rapid sleep onset. This led us to hypothesize that the dissipation of sleep inertia (sleepiness) would be associated with reverse thermoregulatory mechanisms, i.e. distal vasoconstriction. In two sets of experiments with either a nocturnal sleep episode (study 1) or an afternoon nap (study 2) we could show that vasodilatation of hands and feet increased after lights off and that this was reversed after lights on. The time course of the DPG was significantly and positively correlated with subjective sleepiness (KSS), reflecting similar temporal relationships in both studies 1 and 2. The extremities cooled at a rate very closely parallel to the decay of sleepiness [time constants for the exponential decline calculated for study 2: DPG, 0.286 +/- 0.048 h versus KSS, 0.332 +/- 0.050 h; NS], indicating redistribution of heat from the shell to the core during dissipation of sleepiness. There was no statistical evidence that the time course of sleep inertia and its thermophysiological correlates depend on sleep structure prior to awakening. The symmetry between the thermoregulatory processes initiating sleepiness and those dissipating it is striking. In order to directly test our hypothesis, further studies with thermophysiological interventions (e.g. cooling the extremities) are needed.
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The distal-proximal gradient (DPG) is associated with subjective sleepiness and sleep onset latency.
“the distal-proximal gradient (DPG, i.e., difference between skin temperature at distal and proximal locations), which has also been shown to be associated with subjective sleepiness [31] and sleep onset latency [32].”
From Preliminary Results: The Impact of Smartphone Use and Short-Wavelength Light during the Evening on Circadian Rhythm, Sleep and Alertness (2021) · cites this paper as [31]
Thermoregulatory changes preceded by a melatonin rise are robust findings related to psychological cues of relaxation, not time-bound to the evening hours.
“These thermoregulatory changes preceded by a melatonin rise are robust findings related to psychological cues of relaxation (e.g., supine body posture) [53,54] not time-bound to the evening hours, as they are also reported preceding an afternoon nap [31,53,55].”
From Preliminary Results: The Impact of Smartphone Use and Short-Wavelength Light during the Evening on Circadian Rhythm, Sleep and Alertness (2021) · cites this paper as [31]
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- Authors
- Kräuchi, K., Cajochen, C., & Wirz‐Justice, A.
- Affiliations
- Universitäre Psychiatrische Kliniken Basel (CH)
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2004-05-26
- Volume
- 13
- Issue
- 2
- Pages
- 121-127
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- OpenAlex
- W2065354622
- Cited by
- 91
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 3 · 2013: 6 · 2012: 2
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Keywords
- sleep inertia, thermoregulation, sleepiness, vasoconstriction, wakefulness, sleep onset, NAP, subjective sleepiness
- MeSH terms
- Body Temperature Regulation, Humans, Disorders of Excessive Somnolence, Sleep Stages, Vasoconstriction, Vasodilation, Wakefulness, Polysomnography
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