Glos Martin, Fietze Ingo, Blau Alexander, Baumann Gert, Penzel Thomas
Charité-Universitätsmedizin Berlin, CCM-CC11, Centre for Sleep Medicine, Germany.
Charité-Universitätsmedizin Berlin, CCM-CC11, Centre for Sleep Medicine, Germany.
Physiol Behav. 2014 Feb 10;125:45-53. doi: 10.1016/j.physbeh.2013.11.011. Epub 2013 Nov 27.
The autonomic nervous system (ANS) is modulated by sleep and wakefulness. Noninvasive assessment of cardiac ANS with heart rate variability (HRV) analysis is a window for monitoring malfunctioning of cardiovascular autonomic modulation due to sleep deprivation. This study represents the first investigation of dynamic ANS effects and of electrophysiological and subjective sleepiness, in parallel, during 40 h of prolonged wakefulness under constant routine (CR) conditions. In eleven young male healthy subjects, ECG, EEG, EOG, and EMG chin recordings were performed during baseline sleep, during 40 h of sleep deprivation, and during recovery sleep. After sleep deprivation, slow-wave sleep and sleep efficiency increased, whereas HRV - global variability and HRV sympathovagal balance - was reduced (all p<0.05). Sleep-stage-dependent analysis revealed reductions in the sympathovagal balance only for NREM sleep stages (all p<0.05). Comparison of the daytime pattern of CR day one (CR baseline) with that of CR day two (CR sleep deprivation) disclosed an increase in subjective sleepiness, in the amount of unintended sleep, and in HRV sympathovagal balance, with accompaniment by increased EEG alpha attenuation (all p<0.05). Circadian rhythm analysis revealed the strongest influence on heart rate, with less influence on HRV sympathovagal balance. Hour-by-hour analysis disclosed the difference between CR sleep deprivation and CR baseline for subjective sleepiness at almost every single hour and for unintended sleep particularly in the morning and afternoon (both p<0.05). These findings indicate that 40 h of prolonged wakefulness lead in the following night to sleep-stage-dependent reduction in cardiac autonomic modulation. During daytime, an increased occurrence of behavioral and physiological signs of sleepiness was accompanied by diminished cardiac autonomic modulation. The observed changes are an indicator of autonomic stress due to sleep deprivation - which, if chronic, could potentially increase cardiovascular risk.
自主神经系统（ANS）受睡眠和清醒状态的调节。通过心率变异性（HRV）分析对心脏自主神经系统进行无创评估，是监测因睡眠剥夺导致的心血管自主调节功能失调的一个窗口。本研究首次在恒定日常（CR）条件下，对延长清醒40小时期间的动态自主神经系统效应以及电生理和主观嗜睡情况进行了平行调查。在11名年轻男性健康受试者中，在基线睡眠期间、睡眠剥夺40小时期间以及恢复睡眠期间进行了心电图、脑电图、眼电图和颏肌肌电图记录。睡眠剥夺后，慢波睡眠和睡眠效率增加，而HRV（整体变异性和HRV交感迷走平衡）降低（所有p<0.05）。睡眠阶段依赖性分析显示，仅在非快速眼动睡眠阶段交感迷走平衡降低（所有p<0.05）。将第一天CR日（CR基线）与第二天CR日（CR睡眠剥夺）的白天模式进行比较，发现主观嗜睡、意外睡眠量和HRV交感迷走平衡增加，同时脑电图α波衰减增加（所有p<0.05）。昼夜节律分析显示对心率的影响最强，对HRV交感迷走平衡的影响较小。逐小时分析显示，CR睡眠剥夺和CR基线在几乎每个小时的主观嗜睡方面存在差异，在早晨和下午意外睡眠方面差异尤为明显（两者p<0.05）。这些发现表明，延长清醒40小时会导致随后夜晚心脏自主调节出现睡眠阶段依赖性降低。在白天，行为和生理嗜睡迹象的增加伴随着心脏自主调节的减弱。观察到的变化是睡眠剥夺导致自主应激的一个指标——如果是慢性的，可能会增加心血管风险。
