Adverse Impact of Sleep Restriction and Circadian Misalignment on Autonomic Function in Healthy Young Adults.
Adverse Impact of Sleep Restriction and Circadian Misalignment on Autonomic Function in Healthy Young Adults.
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DOI：
10.1161/hypertensionaha.115.06847
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Leproult R
中科院分区：
文献类型：
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作者：
Grimaldi D;Carter JR;Van Cauter E;Leproult R
在流行病学研究中，睡眠不足和昼夜节律紊乱均与不良心血管结局相关，但因果关系的实验证据很少。本研究采用非随机平行组设计比较了昼夜节律失调（CM）和昼夜节律调整（CA）对人类自主神经功能的影响，以在两种情况下实现相同的总睡眠时间。在基线评估（3天，10小时就寝时间）后，26名健康年轻人被分配到睡眠限制（SR; 8个5小时就寝时间），其中固定夜间就寝时间（CA; n=13）或8天中的4天就寝时间延迟8.5小时（CM; n=13）。在基线和SR结束时评估日间动态血压（BP）和心率（HR，CA：n=11，CM：n=10）以及24小时尿去甲肾上腺素水平（NE，CA：n=13，CM：n=13）。在基线和SR的第4和第7夜（CA：n=8，CM：n=12）期间分析夜间HR和心率变异性（HRV）。SR导致两组日间HR显著增加，而BP无变化。SR增加了CM组的24小时尿NE（30±4 vs. 21±2 μg），但在昼夜节律调整组中没有增加（组×条件，p=0.005）。与CM对白天自主神经功能缺乏可检测的影响相反，与不含CM的SR相比，CM的SR引起夜间HR的更大增加，以及HRV迷走指数的更大降低（组×条件，p<0.05）。总之，SR和CM都导致自主神经功能受损，在慢性条件下可能导致心血管风险增加。
Insufficient sleep and circadian rhythm disturbances have been each associated with adverse cardiovascular outcomes in epidemiologic 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. Following baseline assessments (three days with 10h bedtimes), 26 healthy young adults were assigned to sleep restriction (SR; eight 5h bedtimes) with either fixed nocturnal bedtimes (CA; n=13) or bedtimes delayed by 8.5h on 4 of the 8 days (CM; n=13). Daytime ambulatory blood pressure (BP) and heart rate (HR, CA: n=11, CM: n=10), and 24-hour urinary norepinephrine levels (NE, CA: n=13, CM: n=13) were assessed at baseline and the end of SR. Nocturnal HR and heart rate variability (HRV) were analyzed during sleep at baseline and during the 4th and 7th nights of SR (CA: n=8, CM: n=12). SR resulted in a significant increase in daytime HR in both groups, without changes in BP. SR increased 24-hour urinary NE in the CM group (30±4 vs. 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 HRV, 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.