Effects of chronic sleep deprivation on autonomic activity by examining heart rate variability, plasma catecholamine, and intracellular magnesium levels

Magnesium administration may improve heart rate variability in patients with heart failure

BACKGROUND AND AIM

Intracellular magnesium (icMg) depletion may coexist with normomagnesemia. Mg deficiency (serum and/or intracellular) and decreased heart rate variability (HRV) are common in heart failure (HF). Since both are predictors of poor prognosis, it was of interest to evaluate the effect of Mg supplementation on HRV in patients with HF.

METHODS AND RESULTS

We investigated the effect of Mg administration on HRV in normomagnesemic patients with systolic HF. HRV, serum Mg and icMg were determined before and after 5-week 300 mg/day Mg citrate treatment in 16 patients (group 1). The control group included 16 Mg-non-treated HF patients (group 2). HRV was determined by a non-linear dynamics analysis, derived from the chaos theory, which calculates HRV-correlation dimension (HRV-CD). After 5 weeks, serum Mg (mmol/l) increased more significantly in group 1 (from 0.78+/-0.04 to 0.89+/-0.06, p<0.001), than in group 2 (from 0.79+/-0.07 to 0.84+/-0.06, p=0.042). IcMg and HRV-CD increased significantly only in group 1 (from 59+/-7 to 66+/-9 mmol/g cell protein, p=0.025, and from 3.47+/-0.42 to 3.94+/-0.36, p<0.001, respectively). In group 2, the differences in the respective parameters were 63+/-12 to 66+/-9 mmol/g cell protein (p=0.7) and 3.59+/-0.42 to 3.55+/-0.4 (p=0.8).

CONCLUSION

Mg administration to normomagnesemic patients with systolic HF increases serum Mg, icMg and HRV-CD. Increasing of HRV by Mg supplementation may prove beneficial to HF patients.

Dietary fish oil did not prevent sleep deprived rats from a reduction in adipose tissue adiponectin gene expression

Sleep deprivation in humans has been related to weight gain and consequently, increased risk for insulin resistance. In contrast, there is a significant loss of weight in sleep deprived rats suggesting a state of insulin resistance without obesity interference. Thus, we aimed to assess the effects of a rich fish oil dietetic intervention on glucose tolerance, serum insulin and adiponectin, and adipose tissue gene expression of adiponectin and TNF-α of paradoxically sleep deprived (PSD) rats. The study was performed in thirty day-old male Wistar randomly assigned into two groups: rats fed with control diet (soybean oil as source of fat) and rats fed with a fish oil rich diet. After 45 days of treatment, the animals were submitted to PSD or maintained as home cage control group for 96 h. Body weight and food intake were carefully monitored in all groups. At the end of PSD period, a glucose tolerance test was performed and the total blood and adipose tissues were collected. Serum insulin and adiponectin were analyzed. Adipose tissues were used for RT-PCR to estimate the gene expression of adiponectin and TNF-α. Results showed that although fish oil diet did not exert any effect upon these measurements, PSD induced a reduction in adiponectin gene expression of retroperitoneal adipose tissues, with no change in serum adiponectin concentration or in adiponectin and TNF-α gene expression of epididymal adipose tissue. Thus, the stress induced by sleep deprivation lead to a desbalance of adiponectin gene expression.

PER3 polymorphism and cardiac autonomic control: effects of sleep debt and circadian phase

A variable number tandem repeat polymorphism in the coding region of the circadian clock PERIOD3 (PER3) gene has been shown to affect sleep. Because circadian rhythms and sleep are known to modulate sympathovagal balance, we investigated whether homozygosity for this PER3 polymorphism is associated with changes in autonomic nervous system (ANS) activity during sleep and wakefulness at baseline and after sleep deprivation. Twenty-two healthy participants were selected according to their PER3 genotype. ANS activity, evaluated by heart rate (HR) and HR variability (HRV) indexes, was quantified during baseline sleep, a 40-h period of wakefulness, and recovery sleep. Sleep deprivation induced an increase in slow-wave sleep (SWS), a decrease in the global variability, and an unbalance of the ANS with a loss of parasympathetic predominance and an increase in sympathetic activity. Individuals homozygous for the longer allele (PER3(5/5)) had more SWS, an elevated sympathetic predominance, and a reduction of parasympathetic activity compared with PER3(4/4), in particular during baseline sleep. The effects of genotype were strongest during non-rapid eye movement (NREM) sleep and absent or much smaller during REM sleep. The NREM-REM cycle-dependent modulation of the low frequency-to-(low frequency + high frequency) ratio was diminished in PER3(5/5) individuals. Circadian phase modulated HR and HRV, but no interaction with genotype was observed. In conclusion, the PER3 polymorphism affects the sympathovagal balance in cardiac control in NREM sleep similar to the effect of sleep deprivation.

The effects of 28 hours of sleep deprivation on respiratory sinus arrhythmia during tasks with low and high controlled attention demands

Task performance while sleep deprived may be moderated by the controlled attention required by the task (Pilcher, Band, Odle-Dusseau, & Muth, 2007). This study examined the effects of 28 h of sleep deprivation on respiratory sinus arrhythmia (RSA) during tasks with low and high controlled attention demands. The results showed that RSA increased throughout the night for both task types, but was consistently reduced during the low compared to high controlled attention tasks. The increase in RSA was linear for the high controlled attention tasks but curvilinear for the low ones. Hence, RSA followed a circadian pattern during the low controlled attention tasks but not the high ones. These results suggest that the effects of sleep deprivation on task performance may be moderated by parasympathetic activity and task type, and this has implications for task assignment during sustained operations that cause sleep deprivation.

Sleep-stage-specific regulation of plasma catecholamine concentration

The catecholaminergic system is critically involved in the regulation of sleep, wake and arousal states. In the central nervous system, sleep is characterized by low levels of norepinephrine compared to wakefulness, reaching minimum levels during rapid eye movement (REM) sleep. It is not yet clear whether blood catecholamine concentrations (as a measure of sympathetic activity in the body periphery) show a similar sleep stage-dependent decline or depend mainly on a circadian rhythm. Here, we show that during sleep in humans, plasma concentrations of norepinephrine (NE) and epinephrine (E) exhibit a progressive decline associated with the stage of sleep, irrespective of the circadian time of sleep. In a within-subject design, healthy men (n=12) slept for 7h either during daytime or nighttime. Sleep was framed by 3-h periods of wakefulness during which subjects rested in a supine position. We sampled blood at a fast rate (1/10 min) and monitored blood pressure and heart rate continuously. Plasma catecholamine concentrations distinctly declined in a linear fashion as sleep deepened, reaching a minimum during REM sleep both during daytime and nighttime sleep. Diverging from this pattern, cardiovascular parameters indicated lowest blood pressure and heart rate during slow wave sleep (SWS), whereas during REM sleep activity increased almost to waking levels. Because the changes observed here in human blood catecholamine levels closely mimic the changes in brain catecholamine activity, as well-documented in animals, we suggest that the organism's overall catecholamine activity during sleep is well represented by measures of plasma catecholamine concentrations.

Total sleep deprivation inhibits the neuronal nitric oxide synthase and cytochrome oxidase reactivities in the nodose ganglion of adult rats

Sleep disorders are a form of stress associated with increased sympathetic activity, and they are a risk factor for the occurrence of cardiovascular disease. Given that nitric oxide (NO) may play an inhibitory role in the regulation of sympathetic tone, this study set out to determine the NO synthase (NOS) reactivity in the primary cardiovascular afferent neurons (i.e. nodose neurons) following total sleep deprivation (TSD). TSD was performed by the disc-on-water method. Following 5 days of TSD, all experimental animals were investigated for quantitative nicotinamine adenine dinucleotide phosphate-diaphorase (NADPH-d, a co-factor of NOS) histochemistry, neuronal NOS immunohistochemistry and neuronal NOS activity assay. In order to evaluate the endogenous metabolic activity of nodose neurons, cytochrome oxidase (COX) reactivity was further tested. All the above-mentioned reactivities were objectively assessed by computerized image analysis. The clinical significance of the reported changes was demonstrated by alterations of mean arterial blood pressure (MAP). The results indicated that in normal untreated rats, numerous NADPH-d/NOS- and COX-reactive neurons were found in the nodose ganglion (NG). Following TSD, however, both the labelling and staining intensity of NADPH-d/NOS as well as COX reactivity were drastically reduced in the NG compared with normal untreated ganglions. MAP was significantly higher in TSD rats (136+/-4 mmHg) than in normal untreated rats (123+/-2 mmHg). NO may serve as an important sympathoinhibition messenger released by the NG neurons, and decrease of NOS immunoexpression following TSD may account for the decrease in NOS content. In association with the reduction of NOS activity, a defect in NOS expression in the primary cardiovascular afferent neurons would enhance clinical hypertension, which might serve as a potential risk factor in the development of TSD-relevant cardiovascular disturbances.