Adverse impact of sleep restriction and circadian misalignment on autonomic function in healthy young adults
Open accessAbstract
Insufficient sleep and circadian rhythm disturbances have been each associated with adverse cardiovascular outcomes in epidemiological studies, but experimental evidence for a causal link is scarce. The present study compares the impact of circadian misalignment (CM) to circadian alignment (CA) on human autonomic function using a nonrandomized parallel group design to achieve the same total sleep time in both conditions. After baseline assessments (3 days with 10-hour bedtimes), 26 healthy young adults were assigned to sleep restriction (SR; eight 5-hour bedtimes) with either fixed nocturnal bedtimes (CA; n=13) or bedtimes delayed by 8.5 hours on 4 of the 8 days (CM; n=13). Daytime ambulatory blood pressure and heart rate (HR; CA, n=11; CM, n=10) and 24-hour urinary norepinephrine levels (CA, n=13; CM, n=13) were assessed at baseline and the end of SR. Nocturnal HR and HR variability were analyzed during sleep at baseline and during the fourth and seventh nights of SR (CA, n=8; CM, n=12). SR resulted in a significant increase in daytime HR in both groups, without changes in blood pressure. SR increased 24-hour urinary norepinephrine in the CM group (30±4 versus 21±2 μg), but not in the circadian alignment group (group×condition, P =0.005). In contrast to the lack of detectable impact of CM on daytime autonomic function, SR with CM elicited greater increases in nocturnal HR, as well as greater reductions in vagal indices of HR variability, than SR without CM (group×condition, P <0.05). In conclusion, SR and CM both result in impaired autonomic function that could lead, under chronic conditions, to enhanced cardiovascular risk.
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Sympathovagal balance is disrupted by circadian misalignment, as indicated by heart rate variability changes believed to reflect increased cardiovascular disease risk.
“Sympathovagal balance is then disrupted [72], as indicated by changes in heart rate variability that are believed to reflect increased risk of cardiovascular disease (CVD) [73].”
From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [72]
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“Damage to circadian rhythms is also associated with many pathophysiological processes, including autonomic nerve dysfunction (75, 81), increased inflammation (82), and metabolic disorders (83), all of which increase the risk of cardiovascular events.”
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Short Sleep, Insomnia, and Cardiovascular Disease
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Orexin, Sleep, Sympathetic Neural Activity, and Cardiovascular Function
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“Research has demonstrated that combining circadian misalignment with sleep deprivation in experimental studies leads to heightened sympathetic activation and elevated heart rates, and results in a higher level of inflammatory markers than those seen in cases of circadian misalignment and sleep deprivation alone [73,74…”
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“A 2-week study involving 26 healthy adults exposed to restricted sleep revealed a pronounced increase in daytime heart rate, particularly for those sleeping during the day [63].”
BackgroundNon-traditional risk factors for atrial fibrillation: epidemiology, mechanisms, and strategies
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“These studies have shown that circadian disruption, induced by simulating shift work, increases nocturnal sympathetic nervous system activation independently from sleep restriction alone in healthy young adults.(45,46) This laboratory evidence has been corroborated in shift workers by evidence of an elevated BP and he…”
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“Social jetlag adversely affects the circulatory system and increases the risk of cardiovascular disease under chronic conditions (Grimaldi et al., 2016; Forbush et al., 2017).”
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Development of a Measure of Sleep, Circadian Rhythms, and Mood: The SCRAM Questionnaire
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“Depressed mood in physical illnesses is common and leads to an increased mortality rate (Katon, 2003); autonomic function (Grimaldi et al., 2016) and obesity (Haus et al., 2016) have both been associated with sleep and circadian disruption.”
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Pressure Building Against the Clock: The Impact of Circadian Misalignment on Blood Pressure
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“However, evidence suggests that sleep restriction (i.e., 6 h per night) combined with circadian misalignment disrupts overall sympathovagal balance, whereby parasympathetic tone is diminished and sympathetic nervous system influence appears enhanced [55, 65].”
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Core body temperature changes before sleep are associated with nocturnal heart rate variability
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“Previous studies have revealed that sleep restriction and circadian misalignment are factors resulting in impaired autonomic nerve function that might contribute, in the long-term, to increased cardiovascular risk [38].”
BackgroundCircadian misalignment disturbs the skeletal muscle lipidome in healthy young men
Harmsen, J., van Polanen, N., van Weeghel, M., Wefers, J., Hoeks, J., Vaz, F. M., Pras‐Raves, M. L., van Kampen, A. H. C., Schaart, G., van Moorsel, D., et al. (2021) · The FASEB Journal · doi:10.1096/fj.202100143r · Cited by 20 · see citing works
Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep
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Reliability of heart rate variability during stable and disrupted polysomnographic sleep
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“78 This prolonged activation of β 2 ‐ adrenergic receptors may impact cognitive function by influencing these signaling pathways involved in memory regulation.”
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Circadian misalignment impacts cardiac autonomic modulation in adolescence
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“Several possible mechanisms contributed to the mortality increase due to sleep disturbances, such as dysfunction of the autonomic nervous system (57, 58), endothelial function (59), metabolic regulation (60), inflammatory factors secretion (61–63), and arrhythmogenic effects on the heart (64, 65).”
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Adherence to a healthy sleep pattern and new-onset acute kidney injury
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Sleep disturbance and sympathetic neural reactivity in postmenopausal females
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Self-citationBlunted heart rate recovery to spontaneous nocturnal arousals in short-sleeping adults
Bigalke, J. A., Greenlund, I. M., Nicevski, J. R., Smoot, C. A., Oosterhoff, B. J., John‐Henderson, N. A., & Carter, J. R. (2021) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00329.2021 · Cited by 9 · see citing works
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A federated semi-supervised automatic sleep staging method based on relationship knowledge sharing
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Actigraphy-based sleep and muscle sympathetic nerve activity in humans
Bigalke, J. A., Greenlund, I. M., Bigalke, J. R., & Carter, J. R. (2024) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00113.2024 · Cited by 7 · see citing works
Self-citationTaking to “heart” the proposed legislation for permanent daylight saving time
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Self-citationSleep Deprivation and Its Consequences
Chernyshev, O. Y. (2023) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000001323 · Cited by 7 · see citing works
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The validity and reliability of the Persian version of the Athlete Sleep Screening Questionnaire
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“Although no prior study (to the best of our knowledge) has directly assessed the relationship between BISS and HRV, acute or chronic sleep insufficiency is known to adversely impact autonomic function [45, 46].”
BackgroundThe Correlation Between Sleep and Coronary Heart Disease: A Review
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“Sympathetic nervous system overactivation caused by poor sleep leads to an increased heart rate and reduced heart rate variability [109].”
Sleep and cardiometabolic risk. Narrative revision
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“Circadian misalignment refers to conditions of desynchronization between sleep-wake cycles and endogenous biological rhythms (Grimaldi et al. 2016).”
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“While most research on sleep deprivation or restriction has focused on plasma NOR, Grimaldi and colleagues [108] examined 24-hour urinary NOR following eight consecutive days of 5-hour sleep restriction.”
Sueño y riesgo cardiometabólico. Revisión narrativa
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“In physiological level DST has been associated altered cortisol levels, increased levels of plasma pro- and anti-inflammatory markers and lower vagal tone (Grimaldi et al., 2016;Rishi et al., 2020;Wright Jr et al., 2015).”
Background
- Authors
- Grimaldi, D., Carter, J. R., Van Cauter, E., & Leproult, R.
- Affiliations
- Michigan Technological University (US)
- From the Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, IL (D.G., J.R.C., E.V.C., R.L.); and Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.).
- Venue
- Hypertension
- Published
- 2016-07
- Volume
- 68
- Issue
- 1
- Pages
- 243-250
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC4902172
- OpenAlex
- W2414905660
- Cited by
- 153
- References
- 45
- Citations by year
- 2026: 9 · 2025: 20 · 2024: 25 · 2023: 25 · 2022: 19 · 2021: 16 · 2020: 10 · 2019: 11 · 2018: 8 · 2017: 8 · 2016: 2
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - Michigan Tech (Michigan Technological University) (submittedVersion)
- Funders
- University of Chicago
- National Institutes of Health (UL1TR000430)
- National Institute on Aging (P01AG011412)
- National Heart, Lung, and Blood Institute (R01HL072694)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020595, P30DK020595)
- NIH Clinical Center
- National Institute for Occupational Safety and Health (R01-OH009482)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- 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
- Keywords
- sleep restriction, circadian misalignment, circadian alignment, autonomic function, heart rate variability, urinary norepinephrine, blood pressure, nocturnal heart rate, cardiovascular risk, sleep deprivation, young adults
- MeSH terms
- Adult, Analysis of Variance, Autonomic Nervous System, Blood Pressure, Cardiovascular Diseases, Circadian Rhythm, Female, Heart Rate, Humans, Male, Sleep Deprivation, Time Factors, Polysomnography, Blood Pressure Monitoring, Ambulatory, Young Adult, Healthy Volunteers
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