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Sleep Restriction and Recurrent Circadian Disruption Differentially Affects Blood Pressure, Sodium Retention, and
Ciaran J McMullan1,2, Andrew W McHill3,4,5, Joseph T Hull3,4
1Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Frontiers in Physiology
|July 25, 2022
Summary
Chronic sleep restriction and shiftwork increase blood pressure and alter sodium-potassium balance. This study reveals that recurrent circadian disruption (RCD) leads to sodium retention and reduced potassium excretion, independent of aldosterone, impacting cardiovascular health.
Area of Science:
- Cardiovascular Physiology
- Sleep Medicine
- Renal Physiology
Background:
- Chronic sleep restriction (CSR) and shiftwork are linked to hypertension and cardiovascular disease.
- Shiftwork disrupts circadian rhythms, potentially exacerbating cardiovascular risks.
Purpose of the Study:
- To investigate the combined effects of CSR and recurrent circadian disruption (RCD) on blood pressure and renal electrolyte excretion.
- To determine if RCD influences sodium and potassium balance and aldosterone levels.
Main Methods:
- Seventeen healthy participants underwent a 32-day inpatient study with 20-hour "days."
- Participants were randomized to CSR (1:3.3 sleep:wake) or control (1:2 sleep:wake) groups.
- Blood pressure, renal sodium, potassium, and aldosterone excretion were monitored.
Main Results:
- Systolic blood pressure was ~6% higher in CSR during circadian misalignment.
- Renal sodium and potassium excretion exhibited circadian patterns, with potassium influenced by scheduled behaviors.
- Total sodium excretion increased, and potassium decreased per 20-hour day during RCD, without changes in aldosterone.
- A positive total body sodium balance was observed, independent of aldosterone.
Conclusions:
- Recurrent circadian disruption from CSR and shiftwork increases blood pressure and promotes sodium retention.
- The findings suggest mechanisms for adverse cardiovascular and renal effects associated with shiftwork.
- Electrolyte balance is significantly impacted by circadian disruption and scheduled behaviors.
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