Repeating patterns of sleep restriction and recovery - do we get used to it?

描述（由申请人提供）：工作日限制睡眠，周末补觉在工作和学校人群中都是一种极其普遍的模式，这种模式可能持续数十年。许多人认为他们已经习惯了这种反复出现的睡眠限制模式，并且在周末睡懒觉（即获得“恢复睡眠”）完全恢复了一周中失去的睡眠。然而，目前还没有证据支持这一假设，并且仍然不清楚参与应激反应的系统（例如，下丘脑-垂体-肾上腺轴，交感神经-肾上腺系统和炎症系统）如何对这些反复出现的睡眠缺失和恢复模式做出反应。睡眠缺失是一种重要而独特的生理应激源，因为睡眠本身是调节和维持各种生理系统所必需的生物资源。由于应激反应系统的失调与广泛的疾病状态有关，了解这些系统如何受到这些常见的睡眠模式的影响是很重要的。具体来说，压力反应是否会变得习惯性，对反复出现的睡眠限制和恢复性睡眠的反应会减弱，还是会变得敏感，表现出更强的反应？还有一个问题是，通常分配给恢复性睡眠的时间（即周末晚上）是否足以从一周累积的睡眠债中恢复过来。人们对从任何类型的睡眠缺失中恢复知之甚少；然而，初步数据表明，即使是单次睡眠缺失也可能存在生理和主观恢复的分离。我们建议使用23天的住院治疗方案来调查反复暴露于睡眠不足的影响，其中包括三个周期，五天睡眠限制为每晚4小时，然后是两天的恢复睡眠，因此与许多普通人群经历的现实生活中的睡眠限制-恢复模式非常相似。我们将研究HPA，交感-肾上腺和炎症系统的反应模式，以及主观情绪和疼痛评分，在睡眠限制发作之间和发作内。我们还将测试致敏的潜在机制：单核细胞对皮质醇抗炎作用的敏感性受损。这项研究的结果将为反复出现的睡眠限制和恢复的常见模式是否会损害应激反应系统的完整性，从而增加对各种疾病的易感性，包括心血管疾病、情绪和疼痛相关疾病，提供重要的见解。

DESCRIPTION (provided by applicant): Restricting sleep on week days and catching up on sleep over the weekend is an extremely common pattern among both working and school populations, and is one that can persist for decades. Many people believe that they habituate to this recurrent pattern of sleep restriction, and that sleeping in on the weekends (i.e., obtaining 'recovery sleep') fully restores any sleep lost during the week. However, there is currently no evidence to support this hypothesis, and it remains unknown how systems involved in the stress response (e.g., the hypothalamic-pituitary-adrenal [HPA} axis, the sympatho-adrenal system, and the inflammatory system) react to these recurrent sleep loss and recovery patterns. Sleep loss is a significant and unique physiological stressor, as sleep itself is a biological resource necessary to regulate and maintain various physiological systems. As dysregulation of stress response systems is associated with a broad range of disease states, it is important to understand how these systems are affected by these commonly observed sleep patterns. Specifically, does the stress response become habituated and show a decreased response to repeated episodes of sleep restriction and recovery sleep, or does it become sensitized and exhibit an increased response? There also remains a question of whether the time generally allotted for recovery sleep (i.e., weekend nights) is sufficient to recover from the sleep debt accumulated during the week. Little is known about recovery from any type of sleep loss; however, preliminary data suggests that there may be a dissociation of biological and subjective recovery even from single episodes of sleep loss. We propose to investigate the effects of repeated exposure to sleep loss using a 23-day in-hospital protocol with three cycles of five days sleep restricted to 4 hours per night followed by two days of recovery sleep, thus closely resembling a real-life sleep restriction-recovery pattern experienced by many in the general population. We will study response patterns of HPA, sympatho-adrenal, and inflammatory systems, as well as subjective mood and pain ratings, both between and within episodes of sleep restriction. We will also test a potential mechanism of sensitization: impaired sensitivity of monocytes to the anti-inflammatory effects of cortisol. Results from this research will provide critical insights into the question of whether common patterns of recurrent sleep restriction and recovery compromise the integrity of stress response systems, thereby increasing susceptibility to a variety of diseases including cardiovascular, mood- and pain-related disorders.