Everson CA, Szabo A. Recurrent restriction of sleep and inadequate recuperation induce both adaptive changes and pathological outcomes. Am J Physiol Regul Integr Comp Physiol 297: R1430-R1440, 2009. First published August 19, 2009 doi:10.1152/ajpregu.00230.2009.-Chronic restriction of a basic biological need induces adaptations to help meet requisites for survival. The adaptations to chronic restriction of sleep are unknown. A single episode of 10 days of partial sleep loss in rats previously was shown to be tolerated and to result in increased food intake and loss of body weight as principal signs. The purpose of the present experiment was to investigate the extent to which adaptation to chronic sleep restriction would ameliorate short-term effects and result in a changed internal phenotype. Rats were studied during 10 wk of multiple periods of restricted and unrestricted sleep to allow adaptive changes to develop. Control rats received the same ambulatory requirements only consolidated into periods that lessened interruptions of their sleep. The results indicate a latent period of relatively stable food and water intake without weight gain, followed by a dynamic phase marked by enormous increases in food and water intake and progressive loss of body weight, without malabsorption of calories. Severe consequences ensued, marked especially by changes to the connective tissues, and became fatal for two individuals. The most striking changes to internal organs in sleep-restricted rats included lengthening of the small intestine, decreased size of adipocytes, and increased incidence of multilocular adipocytes. Major organs accounted for an increased proportion of total body mass. These changes to internal tissues appear adaptive in response to high energy production, decomposition of lipids, and increased need to absorb nutrients, but ultimately insufficient to compensate for inadequate sleep. sleep rebound; adaptation; metabolism; adiposity; connective tissues; visceral organs CHRONIC DEFICIENCIES IN BASIC biological requirements produce disease. This basic principle has been well established for nutrition, hydration, and oxygen. It also is believed to be true for sleep. However, the specific physiological properties and outcomes of chronic sleep deficiency are not well elucidated. Most studies on the effects of inadequate sleep have employed previously well-rested, young, normal human and animal subjects under conditions of acute and short-term sleep loss. As may be expected, early physical signs of deprivation seem nonspecific, while subject complaints and poor cognitive performance are pronounced (e.g., reviewed in Refs. 7, 38, 48, and 52). Recently, findings in humans undergoing sleep restriction prolonged for six nights suggest sleep loss produces risk factors for obesity, diabetes, and hypertension (45, 71), but questions arise about the extent to which outcomes can be extrapolated to conditions of chronic deficiency and actually become realized. Epidemiological studies show strong linkages between sleep los...