1
|
Messa RM, Benfica MA, Ribeiro LFP, Williams CM, Davidson SRE, Alves ES. The effect of total sleep deprivation on autonomic nervous system and cortisol responses to acute stressors in healthy individuals: A systematic review. Psychoneuroendocrinology 2024; 168:107114. [PMID: 38991306 DOI: 10.1016/j.psyneuen.2024.107114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To synthesise the literature examining the autonomic nervous system (ANS) and cortisol responses to an acute stressor following total sleep deprivation (TSD) in healthy adult subjects. METHODS We conducted a systematic review (CRD42022293857) following the latest PRISMA statement. We searched Medline (via Ovid), Embase (via Ovid), PsycINFO (via Ovid), CINAHL complete and Scopus databases, without year restriction, using search terms related to "sleep deprivation", "stress", "autonomic nervous system" and "cortisol". Two independent team members used pre-defined inclusion/exclusion criteria to assess eligibility and extract data. We used RoB 2 to assess the risk of bias in randomised controlled trials, and ROBINS-I for non-randomised studies. RESULTS Sixteen studies, with 581 participants (mean age = 29 ± 12 years), were eligible for inclusion in the descriptive syntheses. Half of the studies (n = 8) were conducted in the United States of America. The most commonly used study designs were randomised crossover studies (n = 7) and randomised controlled trials (n = 5). Most studies used a single night of TSD (n = 13) which was followed by a psychological (n = 6), physical (n = 5) or psychological and physical (n = 5) acute stressor event. Heart rate (n = 8), cortisol (n = 7) and blood pressure (n =6) were the most reported outcomes, while only a single study used forearm vascular conductance and forearm blood flow. Ten studies found that TSD changed, at least, one marker of ANS or cortisol response. TSD compared with a sleep control condition increased cortisol level (n=1), systolic blood pressure (n=3), diastolic blood pressure (n=2), mean arterial pressure (n=1), and electrodermal activity (n=1) after acute stress. Also, compared with a sleep control, TSD blunted cortisol (n=2), heart rate (n=1) and systolic blood pressure (n=2) responses after acute stress. However, TSD did not change ANS or cortisol responses to acute stressors in 73 % of the total reported outcomes. Furthermore, 10 RCT studies (62.5 %) were assigned as "some concerns" and two RCT studies (12.5 %) were attributed "high" risk of bias. Additionally, one non-randomised trial was classified as "moderate" and three non-randomised trials as "serious" risk of bias. CONCLUSION The markers of ANS and cortisol responses to acute stress after TSD in healthy individuals reveal a scarcity of consistent evidence. The included studies present enough evidence that TSD induces either blunted or exaggerated ANS or cortisol responses to laboratory stresses supporting the "bidirectional multi-system reactivity hypothesis.". It appears that a comprehensive understanding of this phenomenon still lacks robust evidence, and further research is needed to clarify these relationships.
Collapse
Affiliation(s)
- Rozianne M Messa
- Post Graduation Program in Health Sciences (PPGCS), Universidade Estadual de Santa Cruz (UESC), Ilhéus, BA, Brazil; Grupo de Estudos em Psicofisiologia do Esforço Físico (GEPEF), Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil.
| | - Mateus A Benfica
- Post Graduation Program in Health Sciences (PPGCS), Universidade Estadual de Santa Cruz (UESC), Ilhéus, BA, Brazil; Grupo de Estudos em Psicofisiologia do Esforço Físico (GEPEF), Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil.
| | - Luiz F P Ribeiro
- Grupo de Estudos em Psicofisiologia do Esforço Físico (GEPEF), Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil.
| | - Christopher M Williams
- University Centre for Rural Health, Uralba St, Lismore, NSW 2480, Australia; School of Health Sciences, University of Sydney, Missenden Rd, Camperdown, NSW 2050, Australia; Research and Knowledge Translation Directorate, Mid North Coast Local Health District, PO Box 126, Port Macquarie, NSW 2444, Australia.
| | - Simon R E Davidson
- University Centre for Rural Health, Uralba St, Lismore, NSW 2480, Australia; School of Health Sciences, University of Sydney, Missenden Rd, Camperdown, NSW 2050, Australia; Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW 2287, Australia.
| | - Eduardo S Alves
- Post Graduation Program in Health Sciences (PPGCS), Universidade Estadual de Santa Cruz (UESC), Ilhéus, BA, Brazil; Grupo de Estudos em Psicofisiologia do Esforço Físico (GEPEF), Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil; University Centre for Rural Health, Uralba St, Lismore, NSW 2480, Australia; School of Health Sciences, University of Sydney, Missenden Rd, Camperdown, NSW 2050, Australia.
| |
Collapse
|
2
|
Fan B, Tang T, Zheng X, Ding H, Guo P, Ma H, Chen Y, Yang Y, Zhang L. Sleep disturbance exacerbates atherosclerosis in type 2 diabetes mellitus. Front Cardiovasc Med 2023; 10:1267539. [PMID: 38107260 PMCID: PMC10722146 DOI: 10.3389/fcvm.2023.1267539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/10/2023] [Indexed: 12/19/2023] Open
Abstract
Background Short sleep duration and poor sleep quality are important risk factors for atherosclerosis. The use of smart bracelets that measure sleep parameters, such as sleep stage, can help determine the effect of sleep quality on lower-extremity atherosclerosis in patients with type 2 diabetes. Objective To investigate the correlation between sleep disorders and lower-extremity atherosclerosis in patients with type 2 diabetes. Methods After admission, all patients were treated with lower-extremity arterial ultrasound and graded as having diabetic lower-extremity vascular lesions according to the results. A smart bracelet was used to obtain the patient sleep data. The correlation between sleep patterns and diabetic lower-extremity atherosclerosis, diabetic foot, and various metabolic indices was verified. Results Between August 2021 and April 2022, we screened 100 patients with type 2 diabetes, with 80 completing sleep monitoring. Univariate ordered logistic regression analysis indicated that patients with a sleep score below 76 (OR = 2.707, 95%CI: 1.127-6.488), shallow sleep duration of 5.3 h or more (OR=3.040, 95 CI: 1.005-9.202), wakefulness at night of 2.6 times or more (OR = 4.112, 95%CI: 1.513-11.174), and a deep sleep continuity score below 70 (OR = 4.141, 95%CI: 2.460-615.674) had greater risk of high-grade lower limb atherosclerosis. Multivariate ordinal logistic regression analysis revealed that the risk of high-grade lower limb atherosclerosis was higher in patients with 2.6 or more instances of nighttime wakefulness (OR = 3.975, 95%CI: 1.297-12.182) compared with those with fewer occurrences. The sleep duration curve of patients with different grades of diabetic lower-extremity atherosclerosis was U-shaped. According to the results of the one-way analysis of variance, the higher the deep sleep continuity score, the lower the Wagner scale score for diabetic foot (P < 0.05). Conclusions Sleep disorders (long, shallow sleep duration, frequent wakefulness at night, and poor continuity of deep sleep) can worsen lower limb atherosclerosis in patients with type 2 diabetes. This finding can provide a new method for medical professionals to prevent and treat diabetic lower-extremity vascular lesions.
Collapse
Affiliation(s)
- Bingge Fan
- Department of Endocrinology, The Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ting Tang
- Department of War and Rescue Medicine Field Internal Medicine Teaching and Research Office, NCO School, Army Medical University, Shijiazhuang, China
| | - Xiao Zheng
- Department of Orthopedics, The Affiliated Hospital, NCO School of Army Medical University, Shijiazhuang, China
| | - Haixia Ding
- Department of Endocrinology, The Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peng Guo
- Department of Orthopedics, The Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongqing Ma
- Second Department of General Surgery, The Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu Chen
- Department of Cardiology, Bethune International Peaceful Hospital, Shijiazhuang, China
| | - Yichao Yang
- Department of Gastroenterology, Baoding First Central Hospital, Baoding, China
| | - Lihui Zhang
- Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
3
|
Wang H, Yu X, Hu J, Zheng Y, Hu J, Sun X, Ren Y, Chen Y. Effect of Electroacupuncture Versus Cognitive Behavioral Therapy for Perimenopausal Insomnia: Protocol for a Noninferiority Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51767. [PMID: 37943587 PMCID: PMC10667986 DOI: 10.2196/51767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Perimenopausal insomnia (PMI) has a high global incidence, which is common in middle-aged women and is more severe than nonmenopausal insomnia. Effective treatments with fewer side effects and more consistent repeatable results are needed. Acupuncture, a therapy based on traditional Chinese medicine, is safe and may be effective for PMI. It is widely accepted in Western countries, and evidence supports the use of acupuncture as a main or supplementary therapy. Cognitive behavioral therapy is also used to improve sleep quality. It has structured sessions and has been recommended as a first-line treatment for insomnia (cognitive behavioral therapy for insomnia [CBT-I]) by the American Association of Physicians. However, few randomized controlled trials have been conducted to compare the effectiveness of these 2 therapies. This study will be performed in perimenopausal women with insomnia to determine the efficacy of electroacupuncture (EA) versus CBT-I. OBJECTIVE This study aimed to compare the preliminary effectiveness and safety of EA and CBT-I for PMI through a randomized controlled noninferiority study design. METHODS This study is designed as an assessor-blinded, noninferiority, randomized controlled trial. A total of 160 eligible participants with PMI will be randomly divided into 2 groups to receive either EA or CBT-I. Participants in the EA group will receive electroacupuncture for 8 weeks. The intervention will be delivered 3 times weekly for a total of 12 sessions and 2 times weekly for the next 4 weeks. Meanwhile, participants in the control group will undergo CBT-I (once a week) for 8 weeks. Treatment will use 7 main acupoints (GV20, DU24, EX-HN3, EX-HN18, EX-CA1, RN6, and RN4) and an extra 4 acupoints based on syndrome differentiation. The primary outcome is the Insomnia Severity Index. The secondary outcome measures are the Pittsburgh Sleep Quality Index; Menopause-Specific Quality of Life; Menopause Rating Scale; Hamilton Depression Scale; Hamilton Anxiety Scale; hot flash score; and the level of estradiol, follicle-stimulating hormone, and luteinizing hormone in serum. Sleep architecture will be assessed using polysomnograms. RESULTS Participants are currently being recruited. The first participant was enrolled in January 2023, marking the initiation of the recruitment phase. The recruitment process is expected to continue until January 2025, at which point data collection will commence. CONCLUSIONS This trial represents a pioneering effort to investigate the efficacy and safety of EA and CBT-I as interventions for PMI. It is noteworthy that this study is conducted solely within a single center and involves Chinese participants, which is a limitation. Nonetheless, the findings of this study are expected to contribute valuable insights for clinicians engaged in the management of PMI. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2300070981; https://www.chictr.org.cn/showprojEN.html?proj=194561. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51767.
Collapse
Affiliation(s)
- Huixian Wang
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xintong Yu
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Hu
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanting Zheng
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Jia Hu
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Xuqiu Sun
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Ren
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunfei Chen
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
4
|
Neculicioiu VS, Colosi IA, Costache C, Toc DA, Sevastre-Berghian A, Colosi HA, Clichici S. Sleep Deprivation-Induced Oxidative Stress in Rat Models: A Scoping Systematic Review. Antioxidants (Basel) 2023; 12:1600. [PMID: 37627596 PMCID: PMC10451248 DOI: 10.3390/antiox12081600] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Sleep deprivation is highly prevalent in the modern world, possibly reaching epidemic proportions. While multiple theories regarding the roles of sleep exist (inactivity, energy conservation, restoration, brain plasticity and antioxidant), multiple unknowns still remain regarding the proposed antioxidant roles of sleep. The existing experimental evidence is often contradicting, with studies pointing both toward and against the presence of oxidative stress after sleep deprivation. The main goals of this review were to analyze the existing experimental data regarding the relationship between sleep deprivation and oxidative stress, to attempt to further clarify multiple aspects surrounding this relationship and to identify current knowledge gaps. Systematic searches were conducted in three major online databases for experimental studies performed on rat models with oxidative stress measurements, published between 2015 and 2022. A total of 54 studies were included in the review. Most results seem to point to changes in oxidative stress parameters after sleep deprivation, further suggesting an antioxidant role of sleep. Alterations in these parameters were observed in both paradoxical and total sleep deprivation protocols and in multiple rat strains. Furthermore, the effects of sleep deprivation seem to extend beyond the central nervous system, affecting multiple other body sites in the periphery. Sleep recovery seems to be characterized by an increased variability, with the presence of both normalizations in some parameters and long-lasting changes after sleep deprivation. Surprisingly, most studies revealed the presence of a stress response following sleep deprivation. However, the origin and the impact of the stress response during sleep deprivation remain somewhat unclear. While a definitive exclusion of the influence of the sleep deprivation protocol on the stress response is not possible, the available data seem to suggest that the observed stress response may be determined by sleep deprivation itself as opposed to the experimental conditions. Due to this fact, the observed oxidative changes could be attributed directly to sleep deprivation.
Collapse
Affiliation(s)
- Vlad Sever Neculicioiu
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ioana Alina Colosi
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Carmen Costache
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Dan Alexandru Toc
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Alexandra Sevastre-Berghian
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Horațiu Alexandru Colosi
- Division of Medical Informatics and Biostatistics, Department of Medical Education, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Simona Clichici
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| |
Collapse
|
5
|
Paillard T. Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review. Front Hum Neurosci 2023; 14:1146550. [PMID: 37124366 PMCID: PMC10133494 DOI: 10.3389/fnhum.2023.1146550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
This review addresses the effects of sleep deprivation on postural balance based on a comprehensive search of articles dealing with this relationship in the electronic databases PubMed, Google Scholar, and ScienceDirect. Evidence suggests that postural balance is sensitive to acute and chronic sleep deprivation for everyone, including young and healthy subjects. Pathologies, aging and the circadian pattern aggravate and/or accentuate the effects of sleep deprivation on postural balance. It turns out that the different systems of information taking, decision making, and motor execution of the postural balance function are negatively affected by sleep deprivation. For example, regarding the information taking system, the sensitivity of visual perception and visuo-spatial performance and the oculomotricity are disrupted and the vestibulo-ocular reflex and the sensory reweighting are altered. Regarding the decision making system, the different brain areas activated for the regulation of postural balance are less active after sleep deprivation and the executive function and perception of verticality are impaired. Regarding the motor execution system, the agonist-antagonist muscle coordination can be modified. However, the different detrimental effects induced for each system of the postural balance function are not yet fully known and deserve further exploration in order to better understand them.
Collapse
|
6
|
The Impact of Sleep Disturbance on Gut Microbiota, Atrial Substrate, and Atrial Fibrillation Inducibility in Mice: A Multi-Omics Analysis. Metabolites 2022; 12:metabo12111144. [PMID: 36422284 PMCID: PMC9694206 DOI: 10.3390/metabo12111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
This study examined the effect of sleep disturbance on gut microbiota (GM), atrial substrate, and atrial fibrillation (AF) inducibility. C57BL/6 mice were subjected to six weeks of sleep deprivation (SD) using the method of modified multiple-platform. Transesophageal burst pacing was performed to evaluate AF inducibility. Feces, plasma, and an atrium were collected and analyzed by 16s rRNA sequencing, liquid chromatography−mass spectrometry (LC-MS)-based metabolome, histological studies, and transcriptome. Higher AF inducibility (2/30 of control vs. 15/30 of SD, p = 0.001) and longer AF duration (p < 0.001), concomitant with aggravated fibrosis, collagen, and lipid accumulation, were seen in the SD mice compared to control mice. Meanwhile, elevated alpha diversity, higher abundance of Flavonifractor, Ruminococcus, and Alloprevotella, as well as imbalanced functional pathways, were observed in the gut of SD mice. Moreover, the global patterns for the plasma metabolome were altered, e.g., the decreased butanoate metabolism intermediates in SD mice. In addition, disrupted metabolic homeostasis in the SD atrium, such as fatty acid metabolism, was analyzed by the transcriptome. These results demonstrated that the crosstalk between GM and atrial metabolism might be a promising target for SD-mediated AF susceptibility.
Collapse
|
7
|
Effectiveness of regular physical activity in preventing the progression of arterial hypertension: improved cardiovascular autonomic control during sleep. Hypertens Res 2022; 45:1213-1216. [PMID: 35581497 DOI: 10.1038/s41440-022-00942-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/16/2022] [Indexed: 11/08/2022]
|
8
|
Abukanna AMA, Alanazi BFA, Alanazi STA, ALHarbi EAM, Alanazi TMM. Sleep Deficiency as a Risk Factor for Hypertension: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/irvyhqbvik] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|