Cardiovascular Responses to Resistance Exercise Training in Individuals with Chronic Anxiety and Sleep Duration Irregularity

Purpose: Chronic anxiety, evidenced by a clinical diagnosis of generalized anxiety disorder (GAD) or symptoms consistent with GAD, has been linked to irregular sleep patterns that, when present, are accompanied by impaired vascular function and reduced acute blood pressure control, contributing to elevated cardiovascular disease risk. We performed a retrospective analysis to determine whether resistance exercise training (RET) improves outcomes in individuals with chronic anxiety previously identified as having elevated sleep irregularity and concomitant physiological impairments. Methods: Twenty young adults (25±4 years) with chronic anxiety completed 10 weeks of RET. Based on prior characterization, participants were stratified into High (≥67.67 minutes) and Low (<67.67 minutes) total sleep time irregularity (TSTI) groups, representing those with impaired versus relatively preserved vascular and autonomic function, respectively. Primary outcomes included macrovascular function (exercise-induced flow-mediated dilation; FMD) and cardiovagal baroreflex sensitivity (cBRS). Results: Significant Group × RET interactions were observed for all primary outcomes (p < 0.05). Post-hoc analyses showed that the High TSTI group improved FMD (p < 0.01) and cBRS (p = 0.04), whereas the Low TSTI group showed no significant changes (p > 0.05). Conclusions: In this retrospective analysis, individuals with chronic anxiety characterized by elevated sleep irregularity and baseline impairments exhibited significant improvements in vascular and autonomic function following RET. These findings suggest that RET may be particularly effective in targeting cardiovascular dysfunction in higher-risk anxiety phenotypes.