Effects of cold exposure on autonomic changes during the last rapid eye movement sleep transition and morning blood pressure surge in humans

Terry B.J. Kuo, Cian Hui Hong, I. Te Hsieh, Guo She Lee, Cheryl C.H. Yang

Research output: Contribution to journalArticle

8 Citations (Scopus)


Background: Various studies have linked the occurrence of cardiovascular events and low ambient temperatures as well as the morning blood pressure surge (MBPS). We hypothesized that low ambient temperatures produce a higher sympathetic change during the last rapid eye movement (REM) sleep transition and that this may play an important role in cold-related cardiovascular events. Methods: All experiments were carried out on 12 healthy male adults, aged 24.00. ±. 0.74. years, who participated in two experimental conditions randomly (<1. day apart): warm (23. °C) and cold (16. °C). Blood pressure (BP) was measured every 30. min for 24. h by autonomic ambulatory BP monitoring. The electroencephalograms, electrocardiograms, ambient temperature, near-body temperature, and physical activity were recorded by miniature polysomnography for 24. h. Results: The cold conditions resulted in: (i) higher MBPS than under warm conditions; (ii) significant and greater sympathetic index changes during the sleep-wake transition than during cover-to-uncover and supine-to-sit position tests; (iii) the non-REM-REM transition-related sympathetic elevation during the cold conditions being significantly higher in late sleep period than in early sleep period; (iv) at 1. h prior to morning awakening, the value of total power of heart rate variability changes being significantly negatively correlated with the changes of near-body temperature; and (v) significantly higher arousal index and shorter average interval of REM periods than in warm conditions. Conclusion: Cold exposure elevates the amplitude of MBPS and is associated with late sleep stage transition sympathetic activation, which might have important implications for cold-related cardiovascular events.

Original languageEnglish
Pages (from-to)986-997
Number of pages12
JournalSleep Medicine
Issue number8
Publication statusPublished - 2014
Externally publishedYes



  • Cold exposure
  • Heart rate variability
  • Morning blood pressure surge
  • Near-body temperature
  • NREM-REM transition
  • Sleep

ASJC Scopus subject areas

  • Medicine(all)

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