Abstract

Aim: This systematic review evaluated the effects of acute and short-term sleep deprivation on cardiovascular and neuroendocrine physiology in healthy adults, with emphasis on blood pressure, heart rate, Heart Rate Variability (HRV), cortisol, and Hypothalamic-Pituitary-Adrenal (HPA) axis activity. Methods: The review was conducted according to the PRISMA 2020 guidelines. Electronic databases, including PubMed, Embase, Web of Science, Scopus, and Cochrane CENTRAL, were systematically searched for original experimental and observational studies. Risk of bias was assessed using the RoB 2 tool for randomized and crossover trials and ROBINS-I for non-randomized studies. Findings: Eighteen studies met the inclusion criteria, comprising investigations of hemodynamic and autonomic responses (10 studies), HRV (4 studies), and neuroendocrine outcomes (4 studies). Results for blood pressure, heart rate, and sympathetic nerve activity were inconsistent, with some studies reporting no significant changes and others demonstrating elevated resting or stressinduced blood pressure following sleep deprivation. In contrast, HRV findings consistently indicated reduced parasympathetic activity, reflected by lower RMSSD values after both partial and total sleep deprivation. Cortisol and HPAaxis responses remained variable, with studies reporting either heightened stress reactivity or no measurable changes. Conclusion: Sleep deprivation consistently impairs autonomic regulation, whereas cardiovascular and neuroendocrine responses remain protocol-dependent, highlighting the need for standardized experimental designs and outcome assessments.

Keywords: Sleep deprivation, Neuroendocrine, Cortisol, Heart rate variability, Blood pressure, Muscle sympathetic nerve activity