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. 2020 Apr 17;10(3):20190098. doi: 10.1098/rsfs.2019.0098

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© 2020 The Author(s)

Published by the Royal Society. All rights reserved.

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Figure 5. — The impact of chronic sleep disruption and reduced sleep on the promotion and interaction of physiological stress via the hypothalamic-pituitary-adrenal (HPA) and sympatho-adreno-medullary (SAM) axes and psychosocial stress whereby sleep loss and fatigue result in an imbalance between the demands placed upon an individual and an inability of the individual to manage these demands. Ultimately, the combined and interlocking effects of physiological and psychosocial stress lead to emotional, cognitive and physiological pathologies (table 2).