Effect of cold face stimulation on cerebral blood flow in humans

Waking up properly: is there a role of thermoregulation in sleep inertia?

We assume that alertness should be highest at the end of a sleep episode: it is not. There is always sleep inertia upon awakening, which can last minutes to hours, and whose underlying physiological mechanisms are largely unknown. Previously, we had found a functional relationship between the degree of distal vasodilatation (as measured by the distal-proximal skin temperature gradient (DPG) and sleepiness (as measured by subjective ratings), promoting rapid sleep onset. This led us to hypothesize that the dissipation of sleep inertia (sleepiness) would be associated with reverse thermoregulatory mechanisms, i.e. distal vasoconstriction. In two sets of experiments with either a nocturnal sleep episode (study 1) or an afternoon nap (study 2) we could show that vasodilatation of hands and feet increased after lights off and that this was reversed after lights on. The time course of the DPG was significantly and positively correlated with subjective sleepiness (KSS), reflecting similar temporal relationships in both studies 1 and 2. The extremities cooled at a rate very closely parallel to the decay of sleepiness [time constants for the exponential decline calculated for study 2: DPG, 0.286 +/- 0.048 h versus KSS, 0.332 +/- 0.050 h; NS], indicating redistribution of heat from the shell to the core during dissipation of sleepiness. There was no statistical evidence that the time course of sleep inertia and its thermophysiological correlates depend on sleep structure prior to awakening. The symmetry between the thermoregulatory processes initiating sleepiness and those dissipating it is striking. In order to directly test our hypothesis, further studies with thermophysiological interventions (e.g. cooling the extremities) are needed.

Facial cooling-induced bradycardia does not slow pulmonary V.O2 kinetics at the onset of high-intensity exercise

The mechanism(s) underlying the attenuation of the slow component of pulmonary O2 uptake (Vo2) by prior heavy-intensity exercise is (are) poorly understood but may be ascribed to either an intramuscular-metabolic or a circulatory modification resulting from "priming" exercise. We investigated the effects of altering the circulatory dynamics by delayed vagal withdrawal to the circulation induced by the cold face stimulation (CFS) on the Vo2 kinetics during repeated bouts of heavy-intensity cycling exercise. Five healthy subjects (aged 21-43 yr) volunteered to participate in this study and initially performed two consecutive 6-min leg cycling exercise bouts (work rate: 50% of the difference between lactate threshold and maximal Vo2) separated by 6-min baseline rest without CFS as a control (N1 and N2). CFS was then applied separately, by gel-filled cold compresses to the face for 2-min spanning the rest-exercise transition, to each of the first bout (CFS1) or second bout (CFS2) of repeated heavy-intensity exercise. In the control protocol, Vo2 responses in N2 showed a facilitated adaptation compared with those in N1, mainly attributable to the reduction of slow component. CFS application successfully slowed and delayed the heart rate (HR) kinetics (P < 0.05) on transition to exercise [HR time constant; N1: 55.6 +/- 16.0 (SD) vs. CFS1: 69.0 +/- 12.8 s and N2: 55.5 +/- 11.8 vs. CFS2: 64.0 +/- 17.5 s]; however, it did not affect the "primary" Vo2 kinetics [Vo2 time constant; N1: 23.7 +/- 7.9 (SD) vs. CFS1: 20.9 +/- 3.8 s, and N2: 23.3 +/- 10.3 vs. CFS2: 17.4 +/- 6.3 s]. In conclusion, increased vagal withdrawal delayed and slowed the circulatory response but did not alter the Vo2 kinetics at the onset of supra-lactate threshold cycling exercise. As the facilitation of Vo2 subsequent to prior heavy leg cycling exercise is not attenuated by slowing the central circulation, it seems unlikely that this facilitation is exclusively determined by a blood flow-related mechanism.