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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 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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Cites
Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. (1996) · Circulation · doi:10.1161/01.cir.93.5.1043 · Cited by 17,159
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289
Rechtschaffen, A. (1968) · Medical Entomology and Zoology · Cited by 11,772
Hobson, J. A. (1969) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(69)90021-2 · Cited by 5,215
The International Classification of Sleep Disorders
Daroff, R. B. (1991) · Neurology · doi:10.1212/wnl.41.1.160 · Cited by 5,023
Adverse metabolic and cardiovascular consequences of circadian misalignment
Scheer, F. A. J. L., Hilton, M. F., Mantzoros, C. S., & Shea, S. A. (2009) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0808180106 · Cited by 2,351 · cited 3×
“However, this protocol involves reductions in total sleep time, and thus, the role of sleep loss in causing the cardiovascular alterations could not be fully elucidated.(8) Abstract—Insufficient sleep and circadian rhythm disturbances have been each associated with adverse cardiovascular outcomes in epidemiological st…”
InfluentialEEG Arousals: Scoring Rules and Examples
(1992) · SLEEP · doi:10.1093/sleep/15.2.173 · Cited by 2,138
Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk
Meier-Ewert, H. K., Ridker, P. M., Rifai, N., Regan, M. M., Price, N. J., Dinges, D. F., & Mullington, J. M. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.07.050 · Cited by 1,195
Sympathovagal Balance: A Critical Appraisal
Eckberg, D. L. (1997) · Circulation · doi:10.1161/01.cir.96.9.3224 · Cited by 1,087
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“Several earlier reports have reported that sleep deprivation can lead to sympathetic nervous system hyperactivity [30], elevated blood pressure and pulse rate [31, 32] and alterations in glucose metabolism [33].”
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de Souza, M. R., Garcia, A. L. H., Dalberto, D., Picinini, J., Touguinha, L. B. A., Salvador, M. M., & da Silva, J. (2024) · Mutation Research/Genetic Toxicology and Environmental Mutagenesis · doi:10.1016/j.mrgentox.2024.503793 · Cited by 3
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“Disruption of the circadian rhythm by these factors modifies circulatory variables [15] and could act as a trigger for cardiovascular events such as AMI, both through changes in heart rate and vascular reactivity or through rupture of the atheroma plaque [11].”
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“Experimental sleep deprivation has been shown to cause acute increases in blood pressure and heart rate, activation of the sympathetic nervous system.[30] increased salt retention[31,32] and changes in glucose metabolism.”
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Roche, F., Pichot, V., Garet, M., & Berger, M. (2023) · SLEEP · doi:10.1093/sleep/zsad022 · Cited by 1
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Li, Y., HUANG, Y.-L., Hai-Rou, S. U., Gui-Bing, W. U., & Zhi-Xin, Z. H. U. (2025) · 老年心脏病学杂志:英文版 · doi:10.26599/1671-5411.2025.07.008 · Cited by 1
Dupuis, G. L., Kaveney, J., Lessard, E., Wilson, B., McGinnis, G. R., & Perkins, R. K. (2025) · Current Research in Physiology · doi:10.1016/j.crphys.2025.100171 · Cited by 1
“In this same study, systolic blood pressure, diastolic blood pressure, and mean arterial pressure remained unchanged (Grimaldi et al., 2016).”
Jiang, Z. Q., Dou, Y., Lei, Y., Liu, S., Zhou, J., Li, J., Xu, H., Feng, L., Li, Y., Zhang, C., et al. (2026) · Advanced Science · doi:10.1002/advs.202520318 · Cited by 1
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Greenlund, I. M., & Carter, J. R. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85492-4.00019-3 · Cited by 1
Self-citationNavarrete, V. P. Q., Cuvi, N. J. T., Saltos, K. Y. G., & Morales, K. P. H. (2024) · Revista Científica de Salud BIOSANA · doi:10.62305/biosana.v4i1.82 · Cited by 1
Samson, D. R. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.09.16.299792 · Cited by 1
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Tiani, A. G. (2022) · The Research Repository @ WVU (West Virginia University) · doi:10.33915/etd.11340 · Cited by 1
Arora, N., Bhatta, L., Skarpsno, E. S., Dalen, H., Åsvold, B. O., Brumpton, B. M., Richmond, R. C., & Strand, L. B. (2023) · medRxiv · doi:10.1101/2023.04.17.23288680 · Cited by 2
(2016) · Hypertension · doi:10.1161/hypertensionaha.116.08146
Health Effects of Acute and Chronic Sleep Deprivation in Different Age Groups
Shrivastava, D. (2017) · Indian Journal of Sleep Medicine · doi:10.5958/0974-0155.2017.00001.8
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Silvani, A. (2019) · Springer eBooks · doi:10.1007/978-3-319-90305-7_38-1
Chalfant, J. M. (2020) · UKnowledge (University of Kentucky) · doi:10.13023/etd.2020.396
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“It has been shown already that autonomic impairment is associated with sleep restriction (Grimaldi et al., 2016).”
BackgroundKresna, A., Fuk, L. J., Widyahening, I. S., Soemarko, D. S., & Fitriani, D. Y. (2023) · Occupational and Environmental Medicine Journal of Indonesia · doi:10.7454/oemji.v1i2.1022
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Ashokkumar, C., & Paruchuri, T. (2023) · doi:10.31234/osf.io/3e6mv
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Harmsen, J. (2023) · Research Publications (Maastricht University) · doi:10.26481/dis.20231213jh
Zhou, M.-H. (2024) · Advances in Clinical Medicine · doi:10.12677/acm.2024.1472034
Nelson, R. J. (2025) · Oxford University Press eBooks · doi:10.1093/9780197639979.003.0007
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Carter, J. R., Mullington, J. M., & Yang, H. (2025) · doi:10.1093/med/9780197756782.003.0012
Self-citationTell me who you sleep with, and I will tell you how good your sleep is
Suchecki, D. (2025) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2025.102098
Qu, X. R., Cheng, Z., Li, Y. M., Han, T., & Zhang, X. L. (2025) · Scientific Reports · doi:10.1038/s41598-025-00385-9
“…activity and reduced parasympathetic activation during sleep, and have higher prevalence of unhealthy behaviors, such as higher energy intake and poor overall diet quality, which are associated with weight gain and obesity, and higher incidence of metabolic syndrome and type 2 diabetes 28,29 .”
Lam, M. I., Tong, L. K., Xu, Q., & Cheong, P. L. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120098
Chen, G., Ren, J., Shen, Y., Zheng, K., Cai, Y., & Ni, X. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108719
Arora, N., Bhatta, L., Skarpsno, E. S., Dalen, H., Åsvold, B. O., Brumpton, B. M., Richmond, R. C., & Strand, L. B. (2024) · Figshare · doi:10.6084/m9.figshare.24257634
Arora, N., Bhatta, L., Skarpsno, E. S., Dalen, H., Åsvold, B. O., Brumpton, B. M., Richmond, R. C., & Strand, L. B. (2023) · Figshare · doi:10.6084/m9.figshare.24257479
Özkan, Y., Uzun, M., Solak, A., Koca, S. E., Davarcı, E. C., Tuğrul, H. İ., Tülükaş, M. T., Değirmenci, N., Boyacı, N. N., Biberci, S. G., et al. (2026) · Chronobiology International · doi:10.1080/07420528.2026.2709236
Glycemic burden during nocturnal sleep in patients with sleep bruxism across sleep stages
Martynowicz, H., Lubieniecki, P., Wojakowska, A., Fułek, M., Nowacki, D., Slivinskyi, D., Kałużny, M., Madziarska, K., & Wieckiewicz, M. A. (2026) · CRANIO® · doi:10.1080/08869634.2026.2716315
Ye, X., Huang, C., Zhou, J., Qiu, Z., Wu, J., Wu, H., & Mo, L. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1934083
Li, Y., Hu, L.-W., Wang, L.-B., Fan, Y.-Y., Chen, Y., Li, Z., Zhang, Y.-T., Amjad, M., Gui, Z., Chu, C., et al. (2026) · Environmental Science & Technology · doi:10.1021/acs.est.6c07362
Bai, J., Chen, P., Cui, C., & Yang, L. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1917205
“Night-to-night variability in sleep timing produces recurrent misalignment between the behavioral sleep – wake cycle and the endogenous circadian clock, disrupting the temporal coordination of cortisol secretion, sympathovagal balance, and vascular reactivity (16, 32, 33).”
Zeng, H., Lin, J., & Chen, J. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1889670
“In addition, emerging evidence suggests that circadian disruption may promote BP elevation through autonomic imbalance or dysregulated sodium retention (97, 98).”
Metadata
- 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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