Mechanisms and functions of coupling between sleep and temperature rhythms.

Energy metabolism is strongly linked to the circadian rhythms in sleep and body temperature. Both heat production and heat loss show a circadian modulation. Sleep preferably occurs during the circadian phase of decreased heat production and increased heat loss, the latter due to a profound increase in skin blood flow and, consequently, skin warming. The coupling of these rhythms may differ depending on whether they are assessed in experimental laboratory studies or in habitual sleeping conditions. In habitual sleeping conditions, skin blood flow is for a prolonged time increased to a level hardly ever seen during wakefulness. Possible mechanisms linking the rhythms in sleep and core body and skin temperature are discussed, with a focus on causal effects of changes in core and skin temperature on sleep regulation. It is shown that changes in skin temperature rather than in core temperature causally affect sleep propensity. Contrary to earlier suggestions of a functional role of sleep in heat loss, it is argued that sleep facilitates a condition of increased skin blood flow during a prolonged circadian phase, yet limits heat loss and the risk of hypothermia. Sleep-related behavior including the creation of an isolated microclimate of high temperature by means of warm clothing and bedding in humans and the curling up, huddling and cuddling in animals all help limit heat loss The increase in skin blood flow that characterizes the sleeping period may thus not primarily reflect a thermoregulatory drive. There is indirect support for an alternative role of the prolonged period of increased skin blood flow: it may support maintenance of the skin as a primary barrier in host defense.