ArticleSleep2013
Circadian variation of heart rate variability across sleep stages.
Article in Sleep, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
114 citing papers in PubMed, 1 synthesis or guideline pooled it, 228 citations in OpenAlex.
- Sleep Management and Performance in Offshore Sailing Regattas: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Sleep and cardiac autonomic modulation in older adults: Insights from an at-home study with auditory deep sleep stimulation.Journal of sleep research · 2025Trial
- Effects of sleep fragmentation and partial sleep restriction on heart rate variability during night.Scientific reports · 2023Trial
- External conditioning of data collection enhances the information content from wearable sensors.NPJ cardiovascular health · 2026Article
- Circadian regulation of cardiovascular function: from physiology to clinical implications.Genome medicine · 2026Review
- Timing of anesthetic emergence and early postoperative recovery in older adults undergoing thoracic surgery: a retrospective cohort study.BMC anesthesiology · 2026Article
- Machine Learning-Based Classification of Alertness Levels in Elite Shooting Athletes Using Heart Rate Variability.Journal of sports science & medicine · 2026Article
- Effect of Ventilation on Physiological Recovery During Midday Naps: A Heart Rate Variability Analysis of Office Workers.Sensors (Basel, Switzerland) · 2026Article
- Sleep state is superior to resting state for heart rate variability assessment in major depressive disorder.Acta neuropsychiatrica · 2026Article
- Device-assessed sleep health among older patients with heart failure: a cross-sectional study using actigraphy.BMJ open · 2026Article
- Morning Larks and Night Owls: Considering Chronotype in Evaluation of Patients with Pulmonary Hypertension.Annals of the American Thoracic Society · 2026Article
- Perceived sleep disturbance in healthy women with a history of childhood emotional abuse is not reflected in objective sleep measures or nocturnal heart rate variability.Frontiers in psychiatry · 2026Article
- Heart rate variability during wakefulness reflects sleep apnea indicators but remains context-dependent.Frontiers in physiology · 2026Article
- Reduced 24-hour heart rate variability in neurosyphilis: a retrospective case-control study.Frontiers in neurology · 2026Article
- Exploring cardiac autonomic dysfunction in synucleinopathies with parkinsonism through awake-sleep stages: a possible connection to cardiovascular death.BMJ neurology open · 2026Article
- Interpreting heart rate variability in clinical context: a framework for understanding a multidimensional autonomic biomarker.Frontiers in cardiovascular medicine · 2026Review
- Detecting sleep stages after stroke using wearable sensors: machine learning design and challenges.BMJ digital health & AI · 2026Article
- Acupoint Sensitivity in Patients with Primary Insomnia and Its Correlation with Polysomnography and Heart Rate Variability: A Cross-Sectional Study.Nature and science of sleep · 2026Article
- When your heart isn't in it anymore: cardiac correlates of task disengagement.Communications biology · 2025Article
- Differences in the 24-h autonomic nervous activity of outpatients with major depressive disorder with or without hypersomnia: An exploratory observational study.BioPsychoSocial medicine · 2025Article
54 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
STUDY
objectivesNocturnal cardiovascular events are more frequent at the beginning and end of the night. It was proposed that this pattern reflects the nocturnal distribution of sleep and sleep stages. Using heart rate variability (HRV), we recently showed an interaction between the circadian system and vigilance states on the regulation of cardiac rhythmicity. Here, we further investigate this interaction in order to clarify the specific effects of sleep stages on the regulation of the heart.
designParticipants underwent a 72-h ultradian sleep-wake cycle procedure in time isolation consisting of alternating 60-min wake episodes in dim light and 60-min nap opportunities in total darkness.
settingTime isolation suite. PATIENTS OR
participantsFifteen healthy young participants; two were subsequently excluded.
interventionsN/A. MEASUREMENTS AND
resultsThe current study revealed that sleep onset and progression to deeper sleep stages was associated with a shift toward greater parasympathetic modulation, whereas rapid eye movement (REM) sleep was associated with a shift toward greater sympathetic modulation. We found a circadian rhythm of heart rate (HR) and high-frequency power during wakefulness and all non-REM sleep stages. A significant circadian rhythm of HR and sympathovagal balance of the heart was also observed during REM sleep. During slow wave sleep, maximal parasympathetic modulation was observed at ∼02:00, whereas during REM sleep, maximal sympathetic modulation occurred in the early morning.
conclusionThe circadian and sleep stage-specific effects on heart rate variability are clinically relevant and contribute to the understanding of the degree of cardiovascular vulnerability during sleep.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.