Autonomic regulation during sleep and wakefulness: a review with implications for defining the pathophysiology of neurological disorders

Clin Auton Res. 2018 Dec;28(6):509-518. doi: 10.1007/s10286-018-0560-9. Epub 2018 Aug 28.


Cardiovascular and respiratory parameters change during sleep and wakefulness. This observation underscores an important, albeit incompletely understood, role for the central nervous system in the differential regulation of autonomic functions. Understanding sleep/wake-dependent sympathetic modulations provides insights into diseases involving autonomic dysfunction. The purpose of this review was to define the central nervous system nuclei regulating sleep and cardiovascular function and to identify reciprocal networks that may underlie autonomic symptoms of disorders such as insomnia, sleep apnea, restless leg syndrome, rapid eye movement sleep behavior disorder, and narcolepsy/cataplexy. In this review, we examine the functional and anatomical significance of hypothalamic, pontine, and medullary networks on sleep, cardiovascular function, and breathing.

Keywords: Autonomic nervous system; Breathing; Parasympathetic; Sleep; Sympathetic.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Autonomic Nervous System / physiology*
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System / physiopathology
  • Humans
  • Nervous System Diseases / physiopathology*
  • Sleep / physiology*
  • Sleep Wake Disorders / physiopathology
  • Wakefulness / physiology*