Diurnal variation in neurovascular coupling and the impact of sleep quality: a UK Biobank study

Abstract Study Objectives Cerebrovascular events are more frequent in the morning, coinciding with disturbed circadian rhythms and poor sleep quality. Neurovascular coupling (NVC), a marker of neuronal activity and endothelium-dependent cerebrovascular function, may mediate the relationship between cerebrovascular dysfunction and chronic cerebrovascular disease. This study aims to determine whether NVC shows circadian variation and whether it is associated with sleep quality. Methods Functional MRI scans from the UK Biobank were adapted to assess NVC at different time points throughout the day. ANOVA with Tukey post-hoc tests examined NVC differences between 3-hour and 2-hour time blocks starting at 8 a.m. Cosinor models assessed rhythmicity in NVC. General linear models evaluated the impact of sleep quality (a composite score and individual markers: snoring, insomnia, duration, chronotype, and daytime sleepiness) on NVC, adjusting for age, sex, and vascular risk factors. Results Among 36 801 participants, NVC was significantly lower between 11 a.m. and 2 p.m., with a consistent pattern across ages in men but a midday decline in younger women ( 60 years). While the composite measure of sleep quality risk was not associated with a change in NVC (p=.12), a diagnosis of insomnia (p=.04) or sleep apnoea (p=.03) was associated with lower NVC. Conclusions The observed reduction in NVC in the late morning and its association with objective measures of impaired sleep quality suggest a potential role for endothelial dysfunction, potentially contributing to the associated increased cerebrovascular risk.