Antioxidant supplementation reduced oxidative stress and normalized blood pressure control differences between groups, implicating oxidative stress as a key mechanism linking sleep irregularity and CVD risk in young adults with chronic anxiety.
Key Findings
Results
Young adults with high total sleep time irregularity (TSTI) displayed significantly greater oxidative stress than those with low TSTI.
Twenty-five young adults (24 ± 4 yr) with generalized anxiety disorder (GAD) or elevated GAD symptoms were studied.
Oxidative stress was measured via whole blood superoxide levels.
Participants were separated into high TSTI and low TSTI groups via median split based on wrist-worn accelerometry data.
The high TSTI group showed significantly elevated oxidative stress compared to the low TSTI group under placebo conditions.
Results
Young adults with high TSTI displayed significantly lower vascular function compared to those with low TSTI.
Vascular function was assessed using exercise-induced flow-mediated dilation.
The high TSTI group showed significantly lower vascular function than the low TSTI group.
This difference was observed under placebo supplementation conditions.
Flow-mediated dilation is considered a precursor measure of cardiovascular disease development.
Results
Young adults with high TSTI displayed significantly lower cardiovagal baroreflex sensitivity (blood pressure control) compared to those with low TSTI.
Blood pressure control was assessed via cardiovagal baroreflex sensitivity.
The high TSTI group showed significantly lower baroreflex sensitivity than the low TSTI group under placebo conditions.
Cardiovagal baroreflex sensitivity is considered a precursor measure of cardiovascular disease development.
After antioxidant supplementation, blood pressure control differences between groups were normalized.
Results
Acute antioxidant supplementation significantly improved oxidative stress and blood pressure control specifically in the high TSTI group.
Antioxidant supplementation consisted of alpha-lipoic acid, vitamin C, and vitamin E.
Placebo consisted of microcrystalline cellulose.
Oxidative stress was significantly reduced following antioxidant supplementation in the high TSTI group.
Cardiovagal baroreflex sensitivity was significantly improved in the high TSTI group following antioxidant supplementation.
Antioxidant supplementation normalized blood pressure control differences between the high and low TSTI groups.
Results
Antioxidant supplementation improved vascular function (exercise-induced flow-mediated dilation) independent of TSTI group.
Unlike blood pressure control, improvements in vascular function following antioxidant supplementation were not specific to the high TSTI group.
Both high and low TSTI groups showed significantly improved vascular function following antioxidant supplementation.
This suggests that oxidative stress influences vascular function across the full sample, regardless of sleep irregularity level.
This finding contrasts with the group-specific improvements seen for blood pressure control.
Discussion
This study is described as the first to identify oxidative stress as a mediator of early cardiovascular disease risk associated with total sleep time irregularity in young adults with chronic anxiety.
The study population consisted of young adults with GAD or elevated GAD symptoms, a highly prevalent condition in young adults.
TSTI was measured objectively via wrist-worn accelerometry.
The findings suggest that oxidative stress plays a central role in linking chronic anxiety, sleep irregularity, and elevated CVD risk.
The study used a crossover design comparing acute antioxidant versus placebo supplementation within the same participants.
What This Means
This research suggests that in young adults who have chronic anxiety, having an irregular sleep schedule — varying significantly in how much sleep they get from night to night — is linked to higher levels of oxidative stress (a form of cellular damage caused by unstable molecules), worse blood vessel function, and poorer blood pressure regulation. These are all early warning signs of future heart disease. The study involved 25 young adults with generalized anxiety disorder or elevated anxiety symptoms, and split them into groups with more or less irregular sleep based on wrist-worn activity monitors.
The researchers then tested whether giving participants a combination of antioxidants (alpha-lipoic acid, vitamin C, and vitamin E) could reverse these cardiovascular warning signs compared to a placebo. They found that the antioxidant supplement significantly reduced oxidative stress and improved blood pressure regulation specifically in the group with more irregular sleep, essentially closing the gap between the two groups. Improvements in blood vessel function were seen in both groups after taking antioxidants, suggesting oxidative stress affects blood vessel health broadly, not just in those with irregular sleep.
This research suggests that oxidative stress is a key biological pathway through which poor sleep regularity raises heart disease risk in anxious young people — and that this pathway may be modifiable. The findings highlight that sleep irregularity, not just sleep duration, may matter for heart health in people with anxiety, and that oxidative stress could be an important target for future interventions in this population.
Richardson J, Buck E, Weggen J, Bakken B, Fitzpatrick B, Campbell R, et al.. (2026). Examining oxidative stress as a mechanistic link between sleep irregularity and cardiovascular risk in young adults with chronic anxiety.. American journal of physiology. Heart and circulatory physiology. https://doi.org/10.1152/ajpheart.00006.2026