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

描述(申请人提供)：在工作日限制睡眠，在周末补充睡眠，这在工作和学校人群中都是非常常见的模式，而且这种模式可以持续几十年。许多人认为，他们习惯了这种反复出现的睡眠限制模式，周末睡懒觉(即获得恢复睡眠)可以完全恢复一周中失去的任何睡眠。然而，目前还没有证据支持这一假说，目前还不清楚参与应激反应的系统(如下丘脑-垂体-肾上腺[HPA]轴、交感-肾上腺系统和炎症系统)如何对这些反复出现的睡眠丢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压力，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。由于压力反应系统的失调与一系列疾病状态有关，了解这些系统如何受到这些常见睡眠模式的影响是很重要的。具体地说，压力反应是变得习惯性，并对重复的睡眠限制和恢复睡眠表现出降低的反应，还是变得敏感并表现出增强的反应？还有一个问题是，一般分配给恢复睡眠的时间(即周末晚上)是否足以从一周中积累的睡眠债务中恢复过来。人们对从任何类型的失眠中恢复知之甚少；然而，初步数据表明，即使是从单次失眠中恢复，也可能存在生物学和主观恢复的分离。我们建议使用为期23天的住院方案来调查反复暴露于睡眠不足的影响，其中三个周期的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级，包括睡眠限制期间和期间的反应模式。我们还将测试一种潜在的致敏机制：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以下问题提供关键的见解：反复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，从而增加对包括心血管、情绪和疼痛相关疾病在内的各种疾病的易感性。

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.