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Brain and Heart Dynamics pp 1–13Cite as

Physiological Sleep and Cardiovascular Disease

When the Physiological Rhythms Are Mismatch

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Abstract

It is a consensus in literature that sleep is an important modulator of several physiological functions (e.g., cardiovascular, respiratory, and neurobiological function). In fact, a complex and dynamic rhythmic process involving the activation of several cortical, subcortical, and medullar neural circuits mutually interact in order to synchronize the physiological functions with sleep cycles. During physiological sleep regulation, heart rate and blood pressure lower during NREM sleep cycle, with marked increase during REM sleep cycle. In this process, autonomic nervous system has a pivotal role in the hemodynamic regulation sleep-mediated. In fact, several evidences show that the vagal modulation is predominant during NREM sleep cycle while that during REM sleep cycle occur a prevalence of sympathetic modulation. Thus, due to interaction between sympathetic and parasympathetic oscillations, the hemodynamic fluctuations express the effect of the autonomic cardiovascular modulation in each sleep cycle. On the other hand, a growing body of evidences has revealed that chronic sleep deficiency promoted mainly by sleep-disordered breathing (i.e., obstructive sleep apnea) is highly prevalent in patients with cardiovascular diseases. Through a variety of factors including nocturnal hypoxemia and increased oxidative stress, production of pro-inflammatory cytokines, and autonomic and endothelial dysfunctions, a significant overlap among pathophysiology mechanisms of these two conditions has been reported. Therefore, in this chapter we will address the impact of chronic sleep deficiency promoted by obstructive sleep apnea on the cardiovascular system with focus on the autonomic nervous system.

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Authors and Affiliations

  1. Department of Internal Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Edgar Toschi-Dias, Eleonora Tobaldini & Nicola Montano

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Edgar Toschi-Dias, Eleonora Tobaldini & Nicola Montano

  3. Heart Institute (InCor), University of Sao Paulo Medical School, São Paulo, Brazil

    Edgar Toschi-Dias

  4. Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy

    Luigi Ferini-Strambi

Authors
  1. Edgar Toschi-Dias
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  2. Eleonora Tobaldini
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  3. Nicola Montano
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  4. Luigi Ferini-Strambi
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Corresponding author

Correspondence to Luigi Ferini-Strambi .

Editor information

Editors and Affiliations

  1. Dept of Drug Sciences, Pharmacology Sect, University of Pavia, Dept of Drug Sciences, Pharmacology Sect, Pavia, Pavia, Italy

    Stefano Govoni

  2. Dept of Brain and Behavioural Sciences, University of Pavia Dept of Brain and Behavioural Sciences, Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Department of Molecular Medicine, Pavia, Pavia, Italy

    Emilio Vanoli

Section Editor information

  1. Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy

    Ferini Strambi

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Toschi-Dias, E., Tobaldini, E., Montano, N., Ferini-Strambi, L. (2019). Physiological Sleep and Cardiovascular Disease. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-319-90305-7_36-1

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  • DOI: https://doi.org/10.1007/978-3-319-90305-7_36-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90305-7

  • Online ISBN: 978-3-319-90305-7

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