One night on-call: Sleep deprivation affects cardiac autonomic control and inflammation in physicians

Eleonora Tobaldini, Chiara Cogliati, Elisa M. Fiorelli, Vanessa Nunziata, Maddalena A. Wu, Marta Prado, Maurizio Bevilacqua, Daria Trabattoni, Alberto Porta, Nicola Montano

Research output: Contribution to journalArticlepeer-review


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. Result 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. Conclusion 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.

Original languageEnglish
Pages (from-to)664-670
Number of pages7
JournalEuropean Journal of Internal Medicine
Issue number7
Publication statusPublished - Oct 2013


  • Acute sleep deprivation
  • Autonomic nervous system
  • Heart rate variability
  • Inflammation
  • Resident physicians

ASJC Scopus subject areas

  • Internal Medicine


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