In humans it is assumed that a chronic decrease in sleep duration impairs health through the same mechanisms by which acute sleep deprivation and sleep restriction may act, including decreased glucose sensitivity and increased insulin resistance [
39,
40], increased blood pressure and heart rate (e.g. [
39,
41], and blunted nocturnal decline in blood pressure [
42]. Another potential mechanism is increased metabolic rate, since peripheral metabolic rate is increased in insomniacs relative to normal sleepers, in normal sleepers on nights of poor sleep relative to baseline nights [
43], and in patients with fatal familial insomnia [
44]. Consistent with human studies, a recent study found that flies selected through repeated genetic crossings for short and fragmented sleep are hyperactive, show increased body lipid content and reduced lifespan [
45], but whether short sleep per se (without sleep fragmentation or hyperactivity) can affect longevity could not be tested. Our regression analysis found that both short sleep amount and high wake activity were associated with increased risk of death in 4 of the 6 tested lines. These lines included the 2 most extreme short sleeper mutants (
Hk1 and
HkY) as well as their wild-type controls. There was no significant association in the weak hypomorphic
Hk2 mutants and their wild-type controls, although a trend towards a negative association with sleep amount was present in both mutants and controls (first 28 days,
Hk2 p = 0.15, controls p = 0.08), while a trend towards a positive association with wake activity was present in mutants only (first 28 days,
Hk2 p = 0.078). This analysis shows that when both sleep amount and wake activity are used in the same regression, the effects of activity are much reduced, while most of the sleep effects remain significant. Of note, all 6 lines were tested only after repeated outcrossing to wild-type (Canton-S) flies, to control for possible effects of genetic background on lifespan. However, whereas
Hk1 and
HkY mutants and siblings were tested simultaneously,
Hk2 mutants and their controls were tested 4-5 months later, suggesting that perhaps the difference between wild-type siblings of different crosses arises from environmental fluctuations. Overall, these data support the idea that lifespan is affected by many factors, and suggests that in addition to environment and genetic background, sleep may also in some cases affect longevity. Whether the link between sleep and lifespan is causal, however, remains to be determined. Still, we can conclude that, if there is a causal relationship with lifespan, the causal variable is most likely sleep, not activity. Moreover, it is intriguing that
Hk1 and
HkY flies were short sleepers especially early in life, while
Hk2 flies only became short sleepers starting 2 weeks after eclosure. This suggests that the effects of sleep on aging may be especially prominent early in life.
Many studies have found that individuals with disturbed sleep (i.e. who reported either difficulties in falling asleep or regular use of hypnotics) have increased risk of cardiovascular disease [
6,
46], diabetes [
47], and overall mortality [
3,
48,
49]. However, the relative contribution of sleep fragmentation and short sleep duration is difficult to assess. One study specifically tested only individuals with the same total sleep time (~6.5 hours/night) and found that fragmented sleep (>9 microarousals/hour)
per se was associated with increased levels of lipids, cortisol, and blood pressure [
50]. In flies we could not assess the effects of fragmented sleep independently of those of short sleep, because all parameters related to sleep quantity and quality were strongly correlated. It should also be mentioned that brief awakenings are hard to assess in flies, where sleep and waking are usually calculated based on 1-min time bins (microarousals in humans last only a few seconds [
51]). This explains why we and others [
33] counted only 4-5 microarousals/24 h.
Our results also show that the effects of
Hk mutations on the sleep phenotype depend not only on genetic background but also on age and environmental conditions. We previously reported that young adult flies (< 2 week old) carrying
Hk1 and
HkY mutations are short sleepers, while
Hk2 mutants have normal amount of sleep [
28]. Here, we find that
Hk2 mutants become short sleepers when they age, while in old
Hk1 and
HkY mutants the short sleeping phenotype becomes less prominent. These results were observed no matter whether all flies or only healthy flies that lived at least 73 days were included in the analysis, suggesting that they may reflect a real age-dependent change in the way
Hk affects sleep.
In healthy humans the circadian arousal signal in the evening becomes weaker with aging, resulting in more sleep during the so-called "wake maintenance zone" [
52]. In flies Koh and colleagues found a decrease in the strength of the rest/activity rhythm with aging, i.e. sleep became more distributed over the 24-hour cycle, rather than occurring mostly at night. We also found that older flies sleep more at the light-dark and dark-light transitions, when younger flies are most active. Of note, however, these changes occurred mainly between day 20 and day 45 (at ~ half of lifespan), and did not seem to progress further with age. This lack of progression may reflect a ceiling effect, or the fact that aging modulates night vs day sleep preference only during a specific time window in "middle age". It is also possible, however, that the blunted circadian regulation of sleep is due to factors other than aging per se.
In healthy humans aging is associated with a decrease in total sleep time and in sleep efficiency (the number of awakenings after sleep onset increases), although between elderly (60-70 years) and older elderly (>70) there is no change except in sleep efficiency [
32]. One study in flies [
20] found that sleep amount in wild-type (Canton-S) females was significantly lower at day 33 than at day 3, consistent with our results in males. Another study [
33] found no decrease in total sleep duration with aging in male Canton-S flies maintained at 25°C, and a moderate increase in females [
33]. The same study [
33] found that the number of brief awakenings and of sleep episodes increased after ~ day 30, while the duration of sleep episodes decreased, at least in females, and the effects were more pronounced at 25°C and 29°C than at 18°C. In 5 of our 6 tested lines, all kept at 20°C, we did not find clear signs of aging-related sleep fragmentation, including the 3 wild-type lines. In fact, if anything, we found a decrease in the number of brief awakenings in old flies relative to young ones, and except in the case of
Hk2 mutants, no change or an increase in the duration of sleep episodes with aging. The number of sleep episodes did increase mostly at the beginning and at the end of the light period (accounting for the increase in total sleep duration), but only by ~ 10-20%, while Koh and colleagues [
33] reported a > 2-fold increase. We also reared and tested
Hk1 mutants and wild-type siblings at 25°C, but found trends similar to those observed at 20°C, and no clear evidence of sleep fragmentation. It should be stressed, however, that the analysis of brief awakenings in flies (using 1-min bins) may not be sensitive enough to detect subtle changes in sleep quality. Despite this limitation, our results suggest that a decay in sleep quality is not necessarily a consequence of aging in flies.