title: One night on-call: sleep deprivation affects cardiac autonomic control and inflammation in physicians.
abstract: BACKGROUND
  Sleep loss is associated with increased cardiovascular morbidity and mortality. It is known that chronic sleep restriction affects autonomic cardiovascular control and inflammatory response. However, scanty data are available on the effects of acute sleep deprivation (ASD) due to night shifts on the cardiovascular system and its capability to respond to stressor stimuli. The aim of our study was to investigate whether a real life model of ASD, such as "one night on-call", might alter the autonomic dynamic response to orthostatic challenge and modify the immune response in young physicians.
  
  
  METHODS
  Fifteen healthy residents in Internal Medicine were studied before and after one night on-call at Rest and during a gravitational stimulus (head up-tilt test, HUT). Heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were analyzed during Rest and HUT before and after ASD. Plasmatic hormones (epinephrine, norepinephrine, cortisol, renin, aldosterone, ACTH) and tissue inflammatory cytokines were measured at baseline and after ASD.
  
  
  RESULTS
  HRV analysis revealed a predominant sympathetic modulation and a parasympathetic withdrawal after ASD. During HUT, the sympathovagal balance shifted towards a sympathetic predominance before and after ASD. However, the magnitude of the autonomic response was lower after ASD. BPV and BRS remained unchanged before and after ASD as the hormone levels, while IFN-γ increased after ASD compared to baseline.
  
  
  CONCLUSIONS
  In summary, one night of sleep deprivation, at least in this real-life model, seems to affect cardiovascular autonomic response and immune modulation, independently by the activation of the hypothalamic-pituitary axis.
authors.affiliation: Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Tobaldini
authors.forename: Chiara
authors.initials: C
authors.lastname: Cogliati
authors.forename: Elisa M
authors.initials: EM
authors.lastname: Fiorelli
authors.forename: Vanessa
authors.initials: V
authors.lastname: Nunziata
authors.forename: Maddalena A
authors.initials: MA
authors.lastname: Wu
authors.forename: Marta
authors.initials: M
authors.lastname: Prado
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bevilacqua
authors.forename: Daria
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Porta
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006728:Hormones / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008297:Male; D008505:Medical Staff, Hospital; D009551:Night Care; D010561:Personnel Staffing and Scheduling; D012892:Sleep Deprivation / Q000276:immunology* / Q000503:physiopathology*; D014940:Work Schedule Tolerance / Q000502:physiology*
chemical_list: D015415:Biomarkers; D006728:Hormones
keywords: ANS; ASD; Acute sleep deprivation; Autonomic nervous system; BMI; BP; BPV; BRS; HF; HR; HRV; HUT; Heart rate variability; Inflammation; LF; PBMC; Resident physicians; VLF; acute sleep deprivation; autonomic nervous system; baroreflex sensitivity; blood pressure; blood pressure variability; body mass index; head-up tilt; heart rate; heart rate variability; high frequency; low frequency; peripheral blood mononuclear cells; very low frequency