Objective The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease. Methods The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review. Results Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals. Conclusion While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one’s sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.

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Oosthuyse, T, Florence, GE, Correia, A, Smyth, C, and Bosch, AN. Carbohydrate-restricted exercise with protein increases self-selected training intensity in female cyclists but not male runners and cyclists. J Strength Cond Res 35(6): 1547–1558, 2021—Carbohydrate-restricted training challenges preservation of euglycemia and exercise intensity that precludes ergogenic gains, necessitating countering strategies. We investigated the efficacy of ingesting casein protein hydrolysate in overnight-fasted male runners, male cyclists, and female cyclists. Twenty-four overnight-fasted athletes ingested 15.8 g·h−1 casein hydrolysate or placebo-water during exercise (60–80 minutes) comprising an incremental test to exhaustion, steady-state exercise (70% Vmax or 60% peak power output, 87 ± 4% HRmax), and 20-minute time trial (TT) in a double-blind randomized crossover design, with p < 0.05 accepted as significant. Ingesting protein vs. placebo increased metabolic demand {oxygen consumption, +4.7% (95% confidence interval [CI] ± 4%), p = 0.0297; +3.2% (95% CI ± 3.4%), p = 0.061}, heart rate (p = 0.0083; p = 0.007) and rating of perceived exertion (RPE) (p = 0.0266; p = 0.0163) in male cyclists and runners, respectively, but not female cyclists. Protein vs. placebo increased carbohydrate oxidation (+0.26 [95% CI ± 0.13] g·min−1, p = 0.0007) in female cyclists alone. Cyclists reported +2 ± 1 higher RPE than runners (p = 0.0062). Glycemia was maintained only in runners and increased with protein vs. placebo after 20 minutes of steady-state exercise (+0.63 [95% CI ± 0.56] mmol·L−1, p = 0.0285). TT performance with protein vs. placebo ingestion was modestly compromised in runners (−2.8% [95% CI ± 2.2%], p = 0.0018), unchanged in male cyclists (+1.9% [95% CI ± 5.6%], p = 0.5794), and modestly improved in female cyclists (+2.5% [95% CI ± 1.8%], p = 0.0164). Casein hydrolysate ingestion during moderate to hard carbohydrate-restricted exercise increases glycemia in runners, but not cyclists. Casein hydrolysate increases metabolic demand in male athletes and carbohydrate oxidation in female cyclists and is suitable for improving carbohydrate-restricted training intensity in female but not male endurance athletes.