Boudreau · Sleep 2013 · controlled laboratory ultradian sleep-wake cycle study · n=13

Circadian variation of heart rate variability across sleep stages.

Cited 236 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective laboratory physiological study with repeated measures across a controlled protocol

PubMed 24293767 · doi:10.5665/sleep.3230 · record verified 2026-08-26

What was done

Thirteen healthy young participants (15 recruited, 2 excluded) completed a 72-hour ultradian sleep-wake cycle protocol within a time isolation suite. The protocol alternated 60-minute wake episodes in dim light with 60-minute nap opportunities in total darkness while heart rate variability and sleep stages were recorded.

What was found

The abstract reports directional and timing findings without exact numerical metrics or confidence intervals. Sleep onset and progression to deeper sleep stages shifted autonomic modulation toward parasympathetic dominance, whereas REM sleep shifted modulation toward sympathetic dominance. Circadian rhythms in heart rate and high-frequency power were detected during wakefulness and all non-REM stages. REM sleep also exhibited circadian rhythmicity in heart rate and sympathovagal balance. Peak parasympathetic modulation during slow-wave sleep occurred at ~02:00, while peak sympathetic modulation during REM sleep occurred in the early morning.

Why it matters

The findings demonstrate that cardiac autonomic regulation depends on an interaction between endogenous circadian timing and specific sleep stages, helping explain vulnerability windows for nocturnal cardiovascular events.

Limits

The study evaluated a small sample of healthy young participants (n = 13 analyzed), limiting generalizability to older adults or clinical populations with cardiovascular disease. The abstract reports no numerical effect sizes, statistical test values, or dispersion estimates. The 60-minute ultradian nap schedule departs substantially from habitual consolidated sleep architecture.

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