Article Impact Level: HIGH Data Quality: STRONG Summary of SLEEP, zsaf015. https://doi.org/10.1093/sleep/zsaf015 Dr. Natasha Morales-Ghinaglia et al.
Points
- This research investigated the effects of circadian misalignment on heart rate variability (HRV), which reflects cardiac autonomic modulation (CAM), in a cohort of adolescents. The study analyzed sleep and HRV data from 360 participants, with a median age of 16 years.
- Data collection involved actigraphy (minimum of 3 nights), polysomnography (9 hours), and 24-hour Holter monitoring to evaluate sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). Linear regression models were adjusted for confounding factors such as age, sex, BMI, sleep duration, and apnea/hypopnea index.
- A delayed sleep midpoint on weekends was associated with all five nighttime HRV indices, whereas inconsistent sleep patterns during weekdays had a notable impact on three daytime and three nighttime HRV indices. There was no significant correlation found between social jetlag and heart rate variability.
- Results indicated that circadian misalignment (SM, SI, and SJL) was associated with changes in HRV from childhood to adolescence, even when controlling for confounding factors such as sleep duration and BMI.
- Irregular and delayed sleep patterns on both school and non-school days can lead to decreased HRV, affecting cardiac autonomic modulation and increasing cardiovascular risk in adolescents. Additional investigation is required to evaluate the long-term health implications.
Summary
This research focused on examining how circadian misalignment affects heart rate variability (HRV), which serves as an indicator of cardiac autonomic modulation (CAM), in adolescents. Data were gathered from 360 participants, with a median age of 16 years, from the Penn State Child Cohort. The research included a minimum of three nights of actigraphy, nine hours of polysomnography, and 24-hour Holter monitoring of heart rate variability. The evaluation of circadian misalignment involved analyzing sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). The main outcomes focused on five HRV indices recorded during both daytime and nighttime periods. Linear regression models were employed to account for multiple confounding factors including sex, age, BMI, sleep duration, and apnea/hypopnea index.
The findings showed that during breaks, a later sleep measurement on weekends was notably linked to all five nighttime heart rate variability indices. In particular, increased sleep irregularity during weekdays, while attending school, showed a significant correlation with three daytime and three nighttime HRV indices. No significant association was found between SJL and any HRV index. Longitudinal analyses confirmed that both SM, SI, and SJL were linked to changes in nighttime HRV from childhood to adolescence. The results were modified to account for possible confounding factors, such as variations in sleep duration and body mass index.
The findings indicate that a delayed sleep phase on non-school days, along with irregular sleep patterns during school days, plays a role in reduced HRV among adolescents. Circadian misalignment seems to play a crucial role in modifying cardiac autonomic modulation, which may elevate cardiovascular risk among young individuals. Additional investigation is essential to understand the lasting effects of these results on cardiovascular health in adolescents.
Link to the article: https://academic.oup.com/sleep/advance-article-abstract/doi/10.1093/sleep/zsaf015/7960092
References Morales-Ghinaglia, N., He, F., Calhoun, S. L., Vgontzas, A. N., Liao, J., Liao, D., Bixler, E. O., & Fernandez-Mendoza, J. (2025). Circadian misalignment impacts cardiac autonomic modulation in adolescence. SLEEP, zsaf015. https://doi.org/10.1093/sleep/zsaf015
