Propofol-Induced Sleep: Efficacy and Safety in Patients with Refractory Chronic Primary Insomnia

Insomnia, defined as difficulty in falling asleep and/or staying asleep, short sleep duration, or poor quality sleep, is a common sleep disorder affecting 30-40% of adult population. We have conducted a randomized, double-blind, placebo-controlled study to test if anesthesia is therapeutically beneficial in patients with refractory chronic primary insomnia. We have assessed the efficacy and safety of propofol-induced sleep in these patients. This study comprised of 103 patients with refractory chronic primary insomnia (including 59 non-pregnant, non-lactating women; 28-60 years) and the participants were randomized to receive either physiological saline (placebo) (n = 39) or 3.0 g/l propofol (n = 64) in a 2-h continuous intravenous infusion for five consecutive nights. The Leeds Sleep Evaluation Questionnaire was used for the subjective assessment of sleep, and polysomnography was used for the objective measurement of sleep architecture and patterns. The assessments were done prior to and at the end of the 5-day treatment and 6 months after treatment period. The adverse effects of the treatment were also recorded. A 2-h continuous intravenous infusion of 3.0 g/l propofol for five consecutive nights improved the subjective and objective assessments of sleep in 64 patients with refractory chronic primary insomnia. This improvement occurred immediately after the therapy and persisted for 6 months. No serious adverse events were noticed during the period of drug administration or 6 months after the treatment. Propofol therapy is an efficacious and safe choice for restoring normal sleep in patients with refractory chronic primary insomnia.     

L-tyrosine cures, immediate and long term, dopamine-dependent depressions. Clinical and polygraphic studies

Twelve patients with polysommographic and clinical signs of dopamine-dependent depression (DDD) received, after a short-lasting trial with the dopamine agonist Piribedil, a treatment with oral-tyrosine (3,200 mg/day). On the very first day of treatment a return to mood, as judged by clinical impression and MADRS scores was observed. Sleep recordings performed on nights following days 1, 2, 7 and 8 of treatment showed an immediate improvement of those sleep parameters differentiating the more clearly DDD from other types of depression. More than 50 patients have now been treated successfully for periods ranging from a few months to almost 2 years. This treatment is ineffective in other types of depression.     

Sleep in the surgical intensive care unit: continuous polygraphic recording of sleep in nine patients receiving postoperative care.

Sleep was studied in nine patients for two to four days after major non-cardiac surgery by continuous polygraphic recording of electroencephalogram, electrooculogram, and electromyogram. Presumed optimal conditions for sleep were provided by a concerted effort by staff to offer constant pain relief and reduce environmental disturbance to a minimum. All patients were severely deprived of sleep compared with normal. The mean cumulative sleep time (stage 1 excluded) for the first two nights, daytime sleep included, was less than two hours a night. Stages 3 and 4 and rapid eye movement sleep were severely or completely suppressed. The sustained wakefulness could be attributed to pain and environmental disturbance to only minor degree. Sleep time as estimated by nursing staff was often grossly misjudged and consistently overestimated when compared with the parallel polygraphic recording. The grossly abnormal sleep pattern observed in these patients may suggest some fundamental disarrangement of the sleep-wake regulating mechanism.     

Daytime noise and subsequent night sleep in man

The effects of daytime noise on recovery processes during subsequent undisturbed night sleep were studied in six healthy men (21-27 years), exposed to 80 dB (A) pink noise 8 h per day for 2 days. Sleep EEG, ECG, and respiration were recorded in the laboratory for five consecutive nights: two baseline nights, two nights following noise stimulation, and again one baseline night. Additionally questionnaire data were collected, reflecting a subjective impairment of the recovery function of sleep after noise exposure. EEG sleep data of the first post-noise night showed an increase in slow wave sleep with a simultaneous decrease in stage 2 sleep. During the second post-noise night these changes were less prominent. Three subjects additionally showed an instability in the sleep course coinciding with elevated heart and respiration rates. However, altogether the autonomic parameters were not clearly affected by the noise exposure. The findings support the assumption that strong daytime noise may interfere with subsequent sleep processes.     

Changes in the heart rate variability in patients with obstructive sleep apnea and its response to acute CPAP treatment

Introduction

Obstructive Sleep Apnea (OSA) is a major risk factor for cardiovascular disease. The goal of this study was to demonstrate whether the use of CPAP produces significant changes in the heart rate or in the heart rate variability of patients with OSA in the first night of treatment and whether gender and obesity play a role in these differences.

Methods

Single-center transversal study including patients with severe OSA corrected with CPAP. Only patients with total correction after CPAP were included. Patients underwent two sleep studies on consecutive nights: the first night a basal study, and the second with CPAP. We also analyzed the heart rate changes and their relationship with CPAP treatment, sleep stages, sex and body mass index. Twenty-minute segments of the ECG were selected from the sleep periods of REM, no-REM and awake. Heart rate (HR) and heart rate variability (HRV) were studied by comparing the R-R interval in the different conditions. We also compared samples from the basal study and CPAP nights.

Results

39 patients (15 females, 24 males) were studied. The mean age was 50.67 years old, the mean AHI was 48.54, and mean body mass index was 33.41 kg/m² (31.83 males, 35.95 females). Our results showed that HRV (SDNN) decreased after the use of CPAP during the first night of treatment, especially in non-REM sleep. Gender and obesity did not have any influence on our results.

Conclusions

These findings support that cardiac variability improves as an acute effect, independently of gender or weight, in the first night of CPAP use in severe OSA patients, supporting the idea of continuous use and emphasizing that noncompliance of CPAP treatment should be avoided even if it is just once.     

The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment

Background

Sleep disturbance is a major health issue in Japan. This before-after study aimed to evaluate the immediate effects of forest walking in a community-based population with sleep complaints.

Methods

Participants were 71 healthy volunteers (43 men and 28 women). Two-hour forest-walking sessions were conducted on 8 different weekend days from September through December 2005. Sleep conditions were compared between the nights before and after walking in a forest by self-administered questionnaire and actigraphy data.

Results

Two hours of forest walking improved sleep characteristics; impacting actual sleep time, immobile minutes, self-rated depth of sleep, and sleep quality. Mean actual sleep time estimated by actigraphy on the night after forest walking was 419.8 ± 128.7 (S.D.) minutes whereas that the night before was 365.9 ± 89.4 minutes (n = 42). Forest walking in the afternoon improved actual sleep time and immobile minutes compared with forest walking in the forenoon. Mean actual sleep times did not increase after forenoon walks (n = 26) (the night before and after forenoon walks, 380.0 ± 99.6 and 385.6 ± 101.7 minutes, respectively), whereas afternoon walks (n = 16) increased mean actual sleep times from 342.9 ± 66.2 to 475.4 ± 150.5 minutes. The trend of mean immobile minutes was similar to the abovementioned trend of mean actual sleep times.

Conclusions

Forest walking improved nocturnal sleep conditions for individuals with sleep complaints, possibly as a result of exercise and emotional improvement. Furthermore, extension of sleep duration was greater after an afternoon walk compared to a forenoon walk. Further study of a forest-walking program in a randomized controlled trial is warranted to clarify its effect on people with insomnia.     

Changes of Sleep Adaptation in Hospitalized Patients with Depression

Sleep adaptation in an unfamiliar environment, the so-called “first-night effect”, is known to occur in healthy individuals. To avoid the confounding effects of the “first-night effect”, the first-night sleep data are not used in most of sleep studies. In the present study, we examined changes of sleep adaptation in hospitalized patients with depression. Polysomnographic recordings were obtained for two consecutive nights from 14 patients, and sleep parameters were compared between both nights. Total sleep time, sleep latency, awakening times, movement awakening time, sleep efficiency, sleep architecture, rapid eye movement (REM) sleep latency, REM intensity, REM density, REM time, REM cycles, and other indicators showed no significant difference (p > 0.05) between the first and second nights. To conclude, hospitalized patients with depression have relatively less change in sleep adaptation, thus, the data from their first night do not need to be discarded.     

Nocturnal CPAP improves walking capacity in COPD patients with obstructive sleep apnoea

Background

Exercise limitation is an important issue in patients with chronic obstructive pulmonary disease (COPD), and it often co-exists with obstructive sleep apnoea (overlap syndrome). This study examined the effects of nocturnal continuous positive airway pressure (CPAP) treatment on walking capacity in COPD patients with or without obstructive sleep apnoea.

Methods

Forty-four stable moderate-to-severe COPD patients were recruited and completed this study. They all underwent polysomnography, CPAP titration, accommodation, and treatment with adequate pressure. The incremental shuttle walking test was used to measure walking capacity at baseline and after two nights of CPAP treatment. Urinary catecholamine and heart rate variability were measured before and after CPAP treatment.

Results

After two nights of CPAP treatment, the apnoea-hypopnoea index and oxygen desaturation index significantly improved in both overlap syndrome and COPD patients, however these changes were significantly greater in the overlap syndrome than in the COPD group. Sleep architecture and autonomic dysfunction significantly improved in the overlap syndrome group but not in the COPD group. CPAP treatment was associated with an increased walking capacity from baseline from 226.4 ± 95.3 m to 288.6 ± 94.6 m (P < 0.05), and decreased urinary catecholamine levels, pre-exercise heart rate, oxygenation, and Borg scale in the overlap syndrome group. An improvement in the apnoea-hypopnoea index was an independent factor associated with the increase in walking distance (r = 0.564).

Conclusion

Nocturnal CPAP may improve walking capacity in COPD patients with overlap syndrome.

Trial registration

{"type":"clinical-trial","attrs":{"text":"NCT00914264","term_id":"NCT00914264"}}NCT00914264     

Preliminary simulation model toward the study of the effects caused by different mandibular advancement devices in OSAS treatment

Abstract

The paper aims to evaluate the effects caused by a Mandibular Advancement Device (MAD) for Obstructive Sleep Apnoea Syndrome (OSAS) treatment. This study is based on Finite Element Method (FEM) for evaluating the load distribution on temporomandibular joint, especially on the mandibular condyle and disc, and on periodontal ligaments. The stress values on condyle and periodontal ligaments lead authors to consider MAD a safe procedure even for a long period. The obtained results also show the relationship between MAD material and load distribution at the periodontal ligaments. The paper is a step toward future analyses for studying and comparing the effects of MAD features, such as material, shape and dimensions, in order to allow the clinician prescribing the most fitting device.     

Implementation of 12-hour shifts in a Brazilian petrochemical plant: impact on sleep and alertness

A recent worldwide trend in chemical and petrochemical industries is to extend the duration of shifts. Optimization of the labor force to reduce costs is one reason to increase the length of working time in a shift. Implementation of 12h shifts is a controversial decision for managers and scientists. Literature reviews show alertness is lower during the nighttime hours, and sleep duration is reduced and worse during the daytime. The main objective of this study was to evaluate the impacts of 12h shifts on alertness and sleep. To evaluate the duration and quality of sleep and alertness during work, 22 male shift workers on a continuous rotating schedule at a petrochemical plant completed activity logs and estimated alertness using analog 10-cm scales for 30 consecutive days, three times (at 2h, 6h, and 10h of the shift) every work shift. Statistical tests (analysis of variance [ANOVA] and Tukey) were performed to detect differences between workdays and off days. The shift schedule was 2 days/3 nights/4 off days, followed by 3 days/2 nights/5 off days, followed by 2 days/2 nights/5 off days. Sleep duration varied significantly (p < .001) among the work shifts and off days. Comparing work nights, the shortest mean sleep occurred after the second night (mean = 311.4 minutes, SD = 101.7 minutes), followed by the third night (mean = 335.3 minutes, SD = 151.2 minutes). All but one shift (sleep after the first work night) were significantly different from sleep after the first 2 workdays (p < .002). Tukey tests showed no significant differences in sleep quality between workdays and nights, with the exception of sleep after the third day compared to sleep after night shifts. However, significant differences were detected between off days and work nights (p < .01). ANOVA analysis showed borderline differences among perceived alertness during day shifts (p = .073) and significant differences among the hours of the shifts (p = .0005), especially when comparing the 2nd hour of the first day with the 10th hour of all the day shifts. There were no significant differences in perceived alertness during night work among the first, second, and third nights (p = .573), but there were significant differences comparing the times (2nd, 6th, 10th hour) of the night shifts (p < .001). The evaluation of sleep (duration and quality) and level of alertness have been extensively used in the literature as indicators of possible performance decrements at work. The results of this study show poorer sleep after and significantly decreased alertness during night work. Shifts of 12h are usually implemented for technical and economic reasons. These results point out the necessity of a careful trade-off between the financial and technical gains longer shifts might bring and the possible losses due to incidents or accidents from performance decrements during work.     

Sleep after a Bedtime Beverage

Sleep after an inert capsule was compared with sleep after a hot, bedtime, milk-cereal drink (Horlicks). All-night electrophysiological recordings were made with 18 persons on 10 nights each.Restlessness during sleep at the end of the night was diminished after Horlicks in a group of 10 young adults. In an older group of eight adults, mean age 55 years, sleep after Horlicks was of longer total duration and was less broken by periods of wakefulness. In the latter group the improvement associated with Horlicks was most apparent late in the night and it increased with repeated administration.     

Impaired cortical oxygenation is related to mood disturbance resulting from three nights of sleep restriction

Sleep and Biological Rhythms - Chronic sleep restriction adversely effects cognitive performance and mood, resulting in accidents and economic loss. We examined the effects of three nights of sleep...     

Causes of Flowering of Long-Day Potato Species under Short-Day and Cold-Night Conditions

Flowering and tuber formation in high-mountain potato species Solanum sparsipilum Bitt., S. acaule Bitt., S. punae Juz., S. demissum Lindl., and a tuber crop Ullucus tuberosus Caldas. were investigated. All these species are characterized by absolute requirement of long day-length for flowering and short day-length for tuberization. Plants were grown under the following conditions: natural day-length with a photoperiod of 17 h or longer (treatment 1), short days with a photoperiod of 12 h and warm nights (15–20°C) (treatment 2), and short days with cold nights (5–6°C) (treatment 3). In the first treatment, plants produced flowers but no tubers. In the second treatment, plants produced tubers but no flowers. In the third treatment, plants produced both flowers and tubers. In leaves of S. acaule and U. tuberosus, the levels of gibberellins and ABA were determined. A high activity of gibberellins in the third treatment was similar to that in the first treatment, whereas high ABA activity in the third treatment was similar to that in the second treatment. It is supposed that cold nights retard the destruction of GA in plants during the dark period of diurnal cycle and ensure a permanently high level of gibberellins, which facilitates flowering of long-day species under short-day conditions. The high level of ABA is considered a plant response to short-day conditions, which is favorable for tuberization.     

Cardiovascular effects of partial sleep deprivation in healthy volunteers

Sleep deprivation is common in Western societies and is associated with increased cardiovascular morbidity and mortality in epidemiological studies. However, the effects of partial sleep deprivation on the cardiovascular system are poorly understood. In the present study, we evaluated 13 healthy male volunteers (age: 31 ± 2 yr) monitoring sleep diary and wrist actigraphy during their daily routine for 12 nights. The subjects were randomized and crossover to 5 nights of control sleep (>7 h) or 5 nights of partial sleep deprivation (<5 h), interposed by 2 nights of unrestricted sleep. At the end of control and partial sleep deprivation periods, heart rate variability (HRV), blood pressure variability (BPV), serum norepinephrine, and venous endothelial function (dorsal hand vein technique) were measured at rest in a supine position. The subjects slept 8.0 ± 0.5 and 4.5 ± 0.3 h during control and partial sleep deprivation periods, respectively (P < 0.01). Compared with control, sleep deprivation caused significant increase in sympathetic activity as evidenced by increase in percent low-frequency (50 ± 15 vs. 59 ± 8) and a decrease in percent high-frequency (50 ± 10 vs. 41 ± 8) components of HRV, increase in low-frequency band of BPV, and increase in serum norepinephrine (119 ± 46 vs. 162 ± 58 ng/ml), as well as a reduction in maximum endothelial dependent venodilatation (100 ± 22 vs. 41 ± 20%; P < 0.05 for all comparisons). In conclusion, 5 nights of partial sleep deprivation is sufficient to cause significant increase in sympathetic activity and venous endothelial dysfunction. These results may help to explain the association between short sleep and increased cardiovascular risk in epidemiological studies.     

IMPLEMENTATION OF 12-HOUR SHIFTS IN A BRAZILIAN PETROCHEMICAL PLANT: IMPACT ON SLEEP AND ALERTNESS

A recent worldwide trend in chemical and petrochemical industries is to extend the duration of shifts. Optimization of the labor force to reduce costs is one reason to increase the length of working time in a shift. Implementation of 12h shifts is a controversial decision for managers and scientists. Literature reviews show alertness is lower during the nighttime hours, and sleep duration is reduced and worse during the daytime. The main objective of this study was to evaluate the impacts of 12h shifts on alertness and sleep. To evaluate the duration and quality of sleep and alertness during work, 22 male shift workers on a continuous rotating schedule at a petrochemical plant completed activity logs and estimated alertness using analog 10-cm scales for 30 consecutive days, three times (at 2h, 6h, and 10h of the shift) every work shift. Statistical tests (analysis of variance [ANOVA] and Tukey) were performed to detect differences between workdays and off days. The shift schedule was 2 days/3 nights/4 off days, followed by 3 days/2 nights/5 off days, followed by 2 days/2 nights/5 off days. Sleep duration varied significantly (p <. 001) among the work shifts and off days. Comparing work nights, the shortest mean sleep occurred after the second night (mean = 311.4 minutes, SD = 101.7 minutes), followed by the third night (mean = 335.3 minutes, SD = 151.2 minutes). All but one shift (sleep after the first work night) were significantly different from sleep after the first 2 workdays (p <. 002). Tukey tests showed no significant differences in sleep quality between workdays and nights, with the exception of sleep after the third day compared to sleep after night shifts. However, significant differences were detected between off days and work nights (p <. 01). ANOVA analysis showed borderline differences among perceived alertness during day shifts (p =. 073) and significant differences among the hours of theshifts(p =. 0005), especially when comparing the 2nd hour of the first day with the 10th hour of all the day shifts. There were no significant differences in perceived alertness during night work among the first, second, and third nights (p =. 573), but there were significant differences comparing the times (2nd, 6th, 10th hour) of the night shifts (p ≤. 001). The evaluation of sleep (duration and quality) and level of alertness have been extensively used in the literature as indicators of possible performance decrements at work. The results of this study show poorer sleep after and significantly decreased alertness during night work. Shifts of 12h are usually implemented for technical and economic reasons. These results point out the necessity of a careful trade-off between the financial and technical gains longer shifts might bring and the possible losses due to incidents or accidents from performance decrements during work. (Chronobiology International, 17(4), 521–537, 2000)     

On the Influence of Freight Trains on Humans: A Laboratory Investigation of the Impact of Nocturnal Low Frequency Vibration and Noise on Sleep and Heart Rate

Background

A substantial increase in transportation of goods on railway may be hindered by public fear of increased vibration and noise leading to annoyance and sleep disturbance. As the majority of freight trains run during night time, the impact upon sleep is expected to be the most serious adverse effect. The impact of nocturnal vibration on sleep is an area currently lacking in knowledge. We experimentally investigated sleep disturbance with the aim to ascertain the impact of increasing vibration amplitude.

Methodology/Principal Findings

The impacts of various amplitudes of horizontal vibrations on sleep disturbance and heart rate were investigated in a laboratory study. Cardiac accelerations were assessed using a combination of polysomnography and ECG recordings. Sleep was assessed subjectively using questionnaires. Twelve young, healthy subjects slept for six nights in the sleep laboratory, with one habituation night, one control night and four nights with a variation of vibration exposures whilst maintaining the same noise exposure. With increasing vibration amplitude, we found a decrease in latency and increase in amplitude of heart rate as well as a reduction in sleep quality and increase in sleep disturbance.

Conclusions/Significance

We concluded that nocturnal vibration has a negative impact on sleep and that the impact increases with greater vibration amplitude. Sleep disturbance has short- and long-term health consequences. Therefore, it is necessary to define levels that protect residents against sleep disruptive vibrations that may arise from night time railway freight traffic.     

Personality correlates with sleep-wake variables

A mail-in questionnaire study and two confirmatory archival analyses are described. Variables related to personality and measures of sleep timing, sleep quality, and sleep duration were initially assessed by self-report in a sample of 54 working adults (31.5% male, 23-48 yrs). Extraversion and neuroticism were measured by the Eysenck Personality Inventory (EPI), and the level of sub-clinical manic-type symptoms by the Attitude to Life Questionnaire (ATLQ). The quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI) and by questions relating to habitual sleep latency and minutes awake after sleep onset from the Sleep Timing Questionnaire (STQ). The duration and timing of sleep was assessed using the STQ separately for work-week nights (Sunday-Thursday) and for weekend nights (Friday and Saturday). Morningness-eveningness was assessed using the Composite Scale of Morningness (CSM). Two confirmatory analyses using separate archival samples (Study A: n=201, 55.7% male, 20-57 yrs; Study B: n=101, 47.5% male, 18-59 yrs) were then used to confirm specific correlations of interest. In both initial and confirmatory studies, increased sub-clinical manic-type symptoms were found to be significantly associated with later bedtimes and wake-times during the work-week and lower (more evening-type) CSM scores, and higher neuroticism was associated with poorer sleep as indicated by higher PSQI scores. In contrast, no significant correlations emerged between any of the personality variables and any of the sleep duration variables. Personality appears to affect certain aspects of the timing and subjective quality of sleep, but not necessarily its duration.     

Effects of short- and long-term pulsed radiofrequency electromagnetic fields on night sleep and cognitive functions in healthy subjects

There has been wide public discussion on whether the electromagnetic fields of mobile telephones and their base stations affect human sleep or cognitive functioning. As there is evidence for learning and memory-consolidating effects of sleep and particularly of REM sleep, disturbance of sleep by radiofrequency electromagnetic fields might also impair cognitive functions. Previously realized sleep studies yielded inconsistent results regarding short-term exposure. Moreover, data are lacking on the effect that short- and long-term exposure might have on sleep as well as on cognitive functions. Therefore, 10 healthy young male subjects were included and nocturnal sleep was recorded during eight consecutive nights. In the second, third, and last night, we investigated polysomnographic night sleep and cognitive functions. After the adaptation and baseline nights, the participants were exposed to a defined radiofrequency electromagnetic field during the following six nights. We analyzed polysomnographic night sleep according to Rechtschaffen and Kales [1968, Manual of Standardized Terminology, Techniques and Scoring System for Sleep of Human Subjects] as well as by power spectra and correlation dimension. Cognitive functions were investigated by an array of neuropsychological tests. Data analysis was done by comparing the baseline night with the first and last exposure night and the first two sleep cycles of the respective nights. We did not find significant effects, either on conventional sleep parameters or on power spectra and correlation dimension, nor were there any significant effects on cognitive functions. With our results, we are unable to reveal either short-term or cumulative long-term effects of radiofrequency electromagnetic fields on night sleep and cognitive functions in healthy young male subjects.     

Susceptibility to Declarative Memory Interference is Pronounced in Primary Insomnia

Sleep has been shown to stabilize memory traces and to protect against competing interference in both the procedural and declarative memory domain. Here, we focused on an interference learning paradigm by testing patients with primary insomnia (N = 27) and healthy control subjects (N = 21). In two separate experimental nights with full polysomnography it was revealed that after morning interference procedural memory performance (using a finger tapping task) was not impaired in insomnia patients while declarative memory (word pair association) was decreased following interference. More specifically, we demonstrate robust associations of central sleep spindles (in N3) with motor memory susceptibility to interference as well as (cortically more widespread) fast spindle associations with declarative memory susceptibility. In general the results suggest that insufficient sleep quality does not necessarily show up in worse overnight consolidation in insomnia but may only become evident (in the declarative memory domain) when interference is imposed.     

Temporal dissociation between myeloperoxidase (MPO)-modified LDL and MPO elevations during chronic sleep restriction and recovery in healthy young men

Objectives

Many studies have evaluated the ways in which sleep disturbances may influence inflammation and the possible links of this effect to cardiovascular risk. Our objective was to investigate the effects of chronic sleep restriction and recovery on several blood cardiovascular biomarkers.

Methods and Results

Nine healthy male non-smokers, aged 22–29 years, were admitted to the Sleep Laboratory for 11 days and nights under continuous electroencephalogram polysomnography. The study consisted of three baseline nights of 8 hours sleep (from 11 pm to 7 am), five sleep-restricted nights, during which sleep was allowed only between 1 am and 6 am, and three recovery nights of 8 hours sleep (11 pm to 7 am). Myeloperoxidase-modified low-density lipoprotein levels increased during the sleep-restricted period indicating an oxidative stress. A significant increase in the quantity of slow-wave sleep was measured during the first recovery night. After this first recovery night, insulin-like growth factor-1 levels increased and myeloperoxidase concentration peaked.

Conclusions

We observed for the first time that sleep restriction and the recovery process are associated with differential changes in blood biomarkers of cardiovascular disease.