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Curtailed sleep may alter how intense exercise stresses the heart

Previous epidemiological studies have demonstrated that, at the population level, chronically disrupted and shortened sleep increases the risk of several cardiovascular diseases, such as high blood pressure and myocardial infarction.

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In a new study, participants underwent an intense bout of exercise after both normal sleep and after three nights of curtailed sleep. When they exercised after curtailed sleep, the levels of the heart injury biomarker troponin increased slightly more, compared with when the participants performed exercise in their well-rested condition. The study is a smaller pilot study and it is not yet possible to determine if the findings may be of relevance for cardiovascular health. The study is published in the journal Molecular Metabolism.

Previous epidemiological studies have demonstrated that, at the population level, chronically disrupted and shortened sleep increases the risk of several cardiovascular diseases, such as high blood pressure and myocardial infarction. In contrast, physical exercise can reduce the risk of cardiovascular disease. However, it has been unknown whether controlled sleep restriction can modulate cardiac stress during strenuous exercise.

“Exercise is great for the heart, while lack of sleep can adversely impact the cardiovascular system. But it has been unknown whether shortened sleep can modulate the physiologic stress that intense exercise seems to have on the cells of the heart,” says Jonathan Cedernaes, physician and associate professor of medical cell biology at Uppsala University, who led the study.

A specific type of the protein troponin is found in the heart’s muscle cells. Low amounts of troponin can be released after high-intensity training. Levels of troponin are routinely determined in the clinic, as significantly higher levels are seen in the setting of acute cardiovascular events.

“Higher blood levels of troponin after exercise have been linked to a relative increased prospective risk of cardiovascular diseases. It is not really known what the mechanism is, but at the same time, we know that one’s cardiovascular health is modulated through an interplay of lifestyle factors. We therefore thought it would be important to investigate whether the release of troponin during exercise can be affected by sleep restriction. One reason is the fact that many occupations entail work that disrupts sleep, such as for healthcare workers,” says Cedernaes.

Previous studies have found that exercise can counteract certain adverse effects of curtailed sleep on metabolism. Furthermore, data at the population level indicate that exercise can counteract the negative effects of chronic sleep loss on the cardiovascular system.

“Those who report exercising on a regular basis, but get less sleep than the ideal amount, still reduce their risk of dying from cardiovascular disease. At the same time, we know that chronic or recurrent sleep disruption is bad for cardiovascular health. It is therefore possible that a more pronounced lack of sleep in the long run can increase the relative risk that the heart is injured in some way by more intense exercise. But many individuals experience a temporary lack of sleep, and the need for sleep is also very individual,” Cedernaes points out. “The epidemiological evidence related to disturbed sleep per se, applies primarily to chronic lack of sleep and long-term shift work, and are seen when averaging at the population level.”

16 young men, healthy and normal-weight, underwent the study. All were extensively screened for previous cardiovascular disease, as well as for heredity for such conditions. In addition, all participants had normal sleeping habits within the recommended range – that is, they reported getting 7-9 hours of sleep on a regular basis.

The participants were monitored in a sleep laboratory, where their meal and activity schedules were standardized. In one of the two sessions, participants got a normal amount of sleep, three nights in a row. During their other session, the participants were kept awake for half the nights, three nights in a row. On each occasion, blood samples were taken in the evening and in the morning. After both sleep interventions, blood samples were also taken on the last day, both before and after a 30-min-long intense stationary cycling session.

The researchers measured two biomarkers in the blood samples. NT-proBNP reflects the load on the heart. The second protein, troponin, is commonly used as a marker of cardiac injury. The results showed that the levels of NT-proBNP increased in response to exercise, but this increase did not differ depending on the amount of sleep. Blood levels of troponin also increased after the workout. However, for troponin, the increase after exercise was almost 40% higher after three nights of partial sleep restriction, compared with after three nights of normal sleep.

“An important observation was that the levels of troponin and NT-proBNP were not elevated in response to sleep restriction at any time prior to the workout. It is possible that lack of sleep may instead lower the threshold at which an increased exercise load results in measurable stress in heart muscle cells, as may occur in response to strenuous exercise,” says Cedernaes. “However, we noted that the increase in circulating troponin levels following exercise was variable across individuals. Previous research under resting conditions has also hinted at such variability, and it would be interesting to uncover the mechanisms.”

Cedernaes continues: “Today there is no evidence to suggest that it would be harmful to the heart if you exercise regularly when you have slept too little. One can instead turn the argument around: by ensuring that one gets enough sleep, one may further increase the positive impact of physical exercise. While we know that high-intensity training generally has benefits in the long run, our results may be worth considering and exploring in specific groups of individuals. Examples include athletes and the military. These groups may be required to perform at extreme physical levels even under conditions of curtailed sleep. It may be good to further consider the importance of sleep in these contexts, especially as we also know that improving sleep can also improve one’s performance, both cognitively and physically.”

One limitation of the current study was that only 16 individuals were included. The study should be considered as a pilot study that requires further validation and follow up. Such studies are also needed to examine if these changes also apply to other age groups or women.

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Why a UTI hurts — and why that might be a good thing

Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

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Australian researchers have discovered a previously overlooked group of bladder nerves that help detect urinary tract infections (UTIs) and trigger the body’s response to clear them, providing a potential new target for future bladder pain therapies.

The study shows that bladder nerves located close to the lining of the bladder act as a frontline infection sensor, helping the body recognise UTIs and trigger responses that reduce the severity and spread of infection.

UTIs are among the most common bacterial infections worldwide, with more than 400 million cases reported every year. Nearly one in three women will experience UTIs before the age of 24, and many elderly people and those with bladder issues from spinal cord injuries can experience multiple UTIs in a single year.

Symptoms often include frequent urination, a sudden urge to urinate, pain during urination, and pelvic discomfort can be debilitating for some patients.

Flinders University’s Dr Luke Grundy says that while scientists have long understood how the bladder senses as it fills and triggers urination, the role of a specialised group of bladder nerves near the bladder lining has remained unclear.

“Most bladder nerves act like a fuel gauge, telling the brain when the bladder is filling up and needs emptying,” says Dr Grundy, Head of the NeuroUrology Research Group at Flinders University.

“The nerves we studied in this research are different. They sit close to the bladder lining and appear to act more like an early warning system, detecting infection and inflammation.

“They don’t just sense infection. They help coordinate the body’s response to it by triggering pain and urinary frequency, behaviours that appear to help clear bacteria from the bladder as part of the body’s defence system.”

Lead author and recently graduated PhD student Dr Cindy Tay says the discovery changes how these nerves are understood.

“These mucosal nerves have puzzled scientists for almost two decades because they stay quiet while the bladder fills and empties, which is the main job of the bladder,” says Dr Tay.

“What we’ve found is that they have a hidden job — acting as an early warning system that springs into action the moment infection takes hold.”

The research team developed a novel method to selectively study a specialised group of sensory nerves in the bladder lining of mice, revealing that while these nerves play little role in normal bladder function, they become highly responsive during a UTI and help detect and respond to infection.

“When the bladder is healthy, these nerves are relatively quiet, but during a urinary tract infection they become highly sensitive and respond to the presence of bacteria and inflammation,” says Dr Grundy.

“It may feel unpleasant, but urinating more frequently actually helps clear the infection by flushing out the harmful bacteria.”

The study also helps explain why people with conditions affecting nerve function may be more prone to recurrent or severe UTIs.

“If the nerves that detect infection aren’t working properly, the body may not respond as effectively,” says Dr Grundy.

Building on previous research, the new study reveals a deeper understanding of how UTIs affect bladder function and the nervous system, and could help develop new treatments that target these nerves to relieve UTI-related symptoms.

“Our findings provide new insight into how the bladder detects and responds to infection, helping explain the biological processes that drive the pain, urgency and discomfort commonly experienced during UTIs,” says Dr Grundy

Researchers say the next challenge is to develop therapies that ease the pain and urgency associated with UTIs while preserving the protective role these nerves play in fighting infection.

The paper, ‘Bladder mucosal afferents detect UTI and aid pathogen clearance,’ by Cindy Tay, Harman Sharma, Stewart Ramsay (University of Adelaide), Georgia Bourlotos, Sarah K Manning, Natalie E Stevens, Sophie J Miller, Geraint B Rogers, David J Lynn, Feargal J Ryan, Andrea M Harrington (University of Adelaide), Vladimir Zagorodnyuk, Steven L Taylor and Luke Grundy was published in Proceedings of the National Academy of Sciences (PNAS).

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Pregnancy complications can signal heart disease risk years before traditional screening, study finds

Some women, particularly younger women often considered low risk, may face a higher risk of heart disease earlier than previously recognized.

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McGill University researchers have developed a new tool to identify heart disease risk in women earlier in life.

Findings from a study published in JACC: Advances highlight gaps in existing approaches.

“Heart disease is the leading cause of death in women, yet existing risk tools were developed in older populations and ignore factors unique to women,” said senior author Robert Platt, Professor in the Department of Epidemiology, Biostatistics, and Occupational Health and Director of the School of Population and Global Health.

While pregnancy complications are known to be linked to future heart risk, there has been no way to identify which younger women are most at risk, he added.

Detecting risk earlier

Using health data from more than 260,000 women in the UK aged 15 to 45 who had given birth, researchers developed and validated a prediction model to estimate future heart disease risk. Participants were followed for nearly four years after delivery.

The model identified several factors – not included in existing tools – that can help predict risk, including hypertensive disorders of pregnancy, gestational diabetes, preterm birth, PCOS, depression, thyroid disorders, oral contraceptive use and social deprivation.

The findings suggest some women, particularly younger women often considered low risk, may face a higher risk of heart disease earlier than previously recognized.

“Millions of women who give birth each year are never considered candidates for cardiovascular risk assessment simply because of their age,” said co-author Kristian Filion, Professor in the Departments of Medicine and of Epidemiology, Biostatistics, and Occupational Health.

If integrated into routine postpartum care, this tool could enable earlier monitoring, lifestyle counselling or referral to a specialist, potentially helping prevent a heart attack or stroke later in life, he added.

The next step is to validate the model in Canada and the United States. In the longer term, the goal is to integrate a practical calculator into electronic health records so higher-risk patients can be identified earlier.

About the study

Development and Validation of a Prediction Model for Cardiovascular Risk in Reproductive-Aged Women” by Sonia Grandi, Kristian Filion, Jennifer Hutcheon, Graeme Smith, and Robert Platt was published in JACC: Advances. The study was supported by the Canadian Institutes of Health Research.

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Posture can influence your mood and behavior, study suggests

The findings do not mean that changing posture can dramatically transform a person’s life, but it does raise interesting questions about whether everyday features of our environment – such as workplace ergonomics – can subtly influence mood and behavior.

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A person’s posture appears to affect their emotions and decision-making ability more than they realize, according to new research from McGill University. In a recent study, participants sitting upright performed better at a risk-taking task and reported more positive feelings than did their peers in the slouching or control groups.

Though the effects were modest and observed in a laboratory setting, the results highlight the body’s influence on our mood and behavior, said Jorge Armony, professor in the Departments of Psychiatry and Psychology at McGill and senior author of the study.

A cover story to influence body position

Armony and graduate student Soren Wainio-Theberge, who originated the idea for the research and is a co-author of the paper, recruited nearly 200 participants from the McGill community.

After some initial testing on a computer monitor, they asked them to complete a new task on a tablet, under the guise of testing a mobile application. For some, the tablet was positioned on a stand on an adjustable table, to encourage an upright posture while sitting. For others, it was placed flat on the desk, which was also positioned at a lower setting, prompting participants to hunch over.

Participants then completed a risk-taking test, in which players can earn rewards by inflating a virtual balloon, but risk losing everything if it bursts. Over the course of the task, participants in the upright posture took greater risks and tended to earn greater rewards.

“This suggests they were not acting more impulsively but rather were engaging in more effective risk-taking,” explained Armony.

In the accompanying questionnaire, participants in the upright group also reported significantly higher feelings of pride, which is associated with a positive mood.

Bringing new insight to posture research

The findings shed light on the long-debated notion that the body’s posture can influence the mind.

The McGill team tested this relationship while avoiding concerns associated with previous studies.

The researchers avoided telling subjects which posture to adopt, but, rather, influenced their choice without their knowledge. This helped address a common criticism of earlier “power pose” research: that results may simply reflect that participants responded to researchers’ expectations. In post-experiment interviews, most participants indicated that they were unaware their posture had been manipulated.

The researchers also used video software to measure neck angle as a benchmark for posture conformity. In previous studies, this had not often been measured.

The findings do not mean that changing posture can dramatically transform a person’s life, Armony cautioned, but it does raise interesting questions about whether everyday features of our environment – such as workplace ergonomics – can subtly influence mood and behavior.

About the study

Manipulating posture implicitly through environmental constraints influences mood and
risk-taking behaviour
”, by Soren Wainio-Theberge and Jorge Armony, was published in the British Journal of Psychology.

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