Is Balance Control Affected by Sleep Deprivation? A Systematic Review of the Impact of Sleep on the Control of Balance

Abstract

BackgroundSleep is a complex physiological function that should be addressed from different perspectives and consider the circadian rhythm. Sleep deprivation, either acute or chronic, negatively affects several functions, including motor control. Balance control is essential in several daily life activities and balance problems are related to falls.Research QuestionThis review focuses on how sleep conditions impact balance control.MethodsSystematic literature review according to PRISMA guidelines.ResultsThe literature provided strong evidence that acute sleep deprivation impairs postural control. Chronic sleep deprivation as well as low sleep quality had similar effects, although there is a lower number of works addressing this issue. Furthermore, time awake worsens postural controls and it can be used to detect sleepiness and fatigue. The sleep deprivation showed a stronger negative effect on postural control when removing the visual information (eyes closed) than when reducing proprioceptive feedback (soft surface). There is scarce literature about the effects of chronotype, circadian patterns and chronic sleep deprivation, a frequent problem, on balance control; however they consistently indicate that there is an relationship between them. Most of the studies only consider one-night (acute) sleep deprivation without monitoring prior sleep conditions and the circadian rhythm phase of the participants. However, a few studies indicated that these factors must be considered.SignificanceThese results suggest that the sleep conditions of a subject should be considered for several days prior to balance control tests. Therefore, we propose a revision of current postural measurement protocols to include sleep assessment, such as sleep quality questionnaires or actimetry, and to consider the circadian rhythm of the participants to plan the hour of the tests.

Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

“…Sleep deprivation worsened the mean estimation of the subjective visual vertical and postural balance and flattened the diurnal fluctuation of the subjective visual vertical, leading to the disappearance of the diurnal rhythm ( Martin et al, 2018 ). Finally, the chronotype of the subject (e.g., morning chronotype performs better in morning tests than evening chronotype) can also constitute another factor influencing the effects of sleep deprivation on postural balance ( Umemura et al, 2022 ).…”

“…As the sleep deprivation becomes longer, the brain areas such as the thalamus and the prefrontal cortex are less activated probably due to induced brain tissue hypometabolism ( Orzeł-Gryglewska, 2010 ). Sleep deprivation would affect the metabolism of the thalamus, cerebellum and basal ganglia, affecting sensory integration and motor coordination and therefore postural balance ( Umemura et al, 2022 ). Hence, a reduced activation of the thalamus and the prefrontal cortex may cause input integration disturbances related to a lack attentional resources and reduced supervision function ( Fabbri et al, 2006 ; Martin et al, 2018 ).…”

“…Two systematic reviews have already reported the adverse effects of sleep deprivation on postural balance ( Izadi et al, 2022 ; Umemura et al, 2022 ) while another systematic review stated a positive relationship between sleep quality and postural balance ( Kirshner et al, 2022 ). These latter authors suggested most physiological and psychological factors are likely to influence this relationship but the mechanistic explanations remain to be precisely described to better understand and prevent the risk of falls, accidents and work-related injuries.…”

The effect of sleep deprivation on postural stability among physically active young adults

“…Some researchers indicated that the observed changes differed according to time-of-day 4 . The mechanisms of the phenomenon are still unclear 30 . It has been posited that a potential role could be played by reduced adaptation abilities and lapses in attention 31 or modulation by attentional resources 12 .…”

Systematic Metabolic Profiling of Mice with Sleep‐Deprivation

“…[2,3] The "sleep debt" caused by chronic sleep deprivation (SD) can be more harmful than people think. [4] SD can cause depression, fear, and other negative emotions, [5,6] reduce movement and balance skills, [7,8] cause memory and cognitive impairments, [9][10][11] increase food attraction and cause obesity, [12,13] diabetes, [14] cardiovascular diseases, cerebrovascular diseases, [15][16][17] and bone diseases, [18] interfere with immune function, [19,20] and cause an increased risk of cancer, [21] and death. [15] The socioeconomic implications of SD are much more significant than we expected.…”