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SYSTEMATIC REVIEW article

Front. Neurol.

Sec. Sleep Disorders

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1556784

Effects of Sleep Deprivation on Heart Rate Variability: A Systematic Review and Meta-Analysis

Provisionally accepted
Suling  ZhangSuling Zhang1Xiaodan  NiuXiaodan Niu1Jinke  MaJinke Ma1,2Xin  WeiXin Wei3,4Jun  ZhangJun Zhang1,2*Du  WeipingDu Weiping5*
  • 1Department OF Public Basic Teaching , Xi’an Academy of Fine Arts, Xi’an, Shanxi Province, China
  • 2Sports Center, Xi'an Jiaotong University, Xi’an, Shaanxi, China
  • 3School of Software Engineering, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
  • 4College of Humanities Education, Xi'an Eurasian College, xi,an, China
  • 5School of Physical Education and Sport, Ningxia Normal University, guyuan, China

The final, formatted version of the article will be published soon.

Background: Sleep deprivation is prevalent in high-pressure environments and among shift workers, and may contribute to autonomic nervous system (ANS) dysregulation, contributing to cardiovascular diseases, mood disorders, and cognitive impairment. Heart rate variability (HRV), an important indicator of ANS function, reflects fluctuations in sympathetic and parasympathetic activity and is commonly used to assess the autonomic effects of sleep deprivation. However, existing studies exhibit considerable heterogeneity due to inconsistencies in HRV measurement methods, variations in deprivation duration, and inadequate control of confounding factors. Objective: This study aimed to comprehensively evaluate the impact of sleep deprivation on HRV through a systematic review and meta-analysis of randomized controlled trials (RCTs), to elucidate the potential mechanisms underlying sleep deprivation-induced cardiac autonomic dysfunction, and to provide insights for optimizing sleep-related interventions and preventing cardiovascular disease. Methods: A systematic search was conducted in PubMed, Embase, CNKI, Wanfang, and VIP databases for RCTs investigating the effects of sleep deprivation on HRV, covering the period from January 2010 to May 2024. The Cochrane Risk of Bias tool was used for methodological quality assessment. Meta-analyses were performed using Review Manager 5. 4 and Stata 17. 0 software.Results: A total of 11 eligible studies involving 549 participants were included. The meta-analysis revealed that: (1) In the time domain, sleep deprivation was associated with a non-significant reduction in SDNN (P > 0. 05), while RMSSD showed a significant decrease (P < 0. 05). (2) In the frequency domain, both LF and LF/HF significantly increased after sleep deprivation (P < 0. 05), whereas HF showed a decreasing trend that did not reach statistical significance (P > 0. 05).This meta-analysis indicates that sleep deprivation may impair cardiac autonomic function, as evidenced by decreased RMSSD and increased LF and LF/HF, suggesting sympathetic predominance and vagal suppression. However, changes in other HRV indices such as SDNN and HF were not statistically significant. These findings imply a potential disruption of the dynamic balance between sympathetic and parasympathetic activity following sleep deprivation. Future research should adopt standardized HRV measurement protocols to validate these findings and further explore the underlying physiological mechanisms.

Keywords: Sleep Deprivation, HRV, Autonomic nervous, Systematic review, Meta-analysis

Received: 11 Jan 2025; Accepted: 22 Jul 2025.

Copyright: © 2025 Zhang, Niu, Ma, Wei, Zhang and Weiping. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jun Zhang, Sports Center, Xi'an Jiaotong University, Xi’an, 710049, Shaanxi, China
Du Weiping, School of Physical Education and Sport, Ningxia Normal University, guyuan, China

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