ArticleSleep2025
Circadian misalignment impacts cardiac autonomic modulation in adolescence.
Article in Sleep, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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
4 citing papers in PubMed.
- Variable Morning Melatonin Profiles Limit Determination of Dim-Light Melatonin Offset in Preschool-Aged Children.Journal of biological rhythms · 2026Article
- Social epidemiology of multidimensional sleep health in early adolescence.Pediatric research · 2026Article
- Cardiac rhythm development: A wearable device index of risk for physical and mental illness in adolescence.medRxiv : the preprint server for health sciences · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
STUDY
objectivesAlthough heart rate variability (HRV), a marker of cardiac autonomic modulation (CAM), is known to predict cardiovascular morbidity, the circadian timing of sleep is also involved in autonomic modulation. We examined whether circadian misalignment is associated with blunted HRV in adolescents as a function of entrainment to school or on-breaks.
methodsWe evaluated 360 subjects from the Penn State Child Cohort (median 16 years) who had at least 3-night at-home actigraphy (ACT), in-lab 9-h polysomnography, and 24-h Holter-monitoring HRV data. ACT-measured metrics of circadian misalignment included sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). Five 24-h, daytime, and nighttime frequency- and time-domain HRV indices were the primary outcomes. Linear regression models adjusted for sex, race/ethnicity, age, body mass index, apnea/hypopnea index, sleep duration, and its variability. These associations were also examined as a function of being in-school or on-break.
resultsWhile on-break, a later SM on weekends was significantly associated with all five nighttime HRV indices. While in-school, greater SI on weekdays was significantly associated with three daytime and three nighttime HRV indices. Greater SJL was not associated with any HRV index. Longitudinal analyses confirmed the association of adolescent SM, SI, and SJL with change in nighttime HRV since childhood.
conclusionsAn irregular sleep phase during days of entrainment to social demands and a delayed sleep phase during ad libitum days are associated with blunted HRV in adolescents. Circadian misalignment contributes to increased cardiovascular risk via an altered CAM in youth.
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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.