Heart rate variability during sleep as a function of the sleep cycle

Versace, Francesco; Mozzato, Manola; Tona, Giuliano De Min; Cavallero, Corrado; Stegagno, Luciano

doi:10.1016/s0301-0511(03)00052-8

Cited by 63 publications

(40 citation statements)

References 16 publications

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“…Both SB study groups show a gradual increase in mean RR intervals (lower heart rhythm) from the first to the fourth sleep cycle, which is also seen in the control group and has been previously reported (Burgess et al. , 2001; Versace et al. , 2003).…”

Section: Discussionsupporting

confidence: 85%

Sleep bruxism is associated to micro‐arousals and an increase in cardiac sympathetic activity

Huynh

Kato

Rompré

et al. 2006

Journal of Sleep Research

181

134

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SUMMAR Y Sleep bruxism (SB) subjects show a higher incidence of rhythmic masticatory muscle activity (RMMA) than control subjects. RMMA is associated with sleep microarousals. This study aims to: (i) assess RMMA/SB episodes in relation to sleep cycles; (ii) establish if RMMA/SB and micro-arousals occur in relation to the slow wave activity (SWA) dynamics; (iii) analyze the association between RMMA/SB and autonomic cardiac activity across sleep cycles. Two nights of polygraphic recordings were made in three study groups (20 subjects each): moderate to high SB, low SB and control. RMMA episodes were considered to occur in clusters when several groups of RMMA or non-specific oromotor episodes were separated by less than 100 s. Correlations between sleep, RMMA/SB index and heart rate variability variables were assessed for the first four sleep cycles of each study group. Statistical analyses were done with SYSTAT and SPSS. It was observed that 75.8% of all RMMA/SB episodes occurred in clusters. Micro-arousal and SB indexes were highest during sleep cycles 2 and 3 (P < 0.001). Within each cycle, micro-arousal and RMMA/SB indexes showed an increase before each REM sleep (P £ 0.02). The cross-correlation plot for microarousal index showed positive association from 4 min preceding SB onset in the moderate to high SB subjects (P £ 0.06). The cross-correlation plot revealed that SWA decreases following SB onset (P £ 0.05). Further cross-correlation analysis revealed that a shift in sympatho-vagal balance towards increased sympathetic activity started 8 min preceding SB onset (P £ 0.03). In moderate to severe SB subjects, a clear increase in sympathetic activity precedes SB onset.

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Section: Discussionsupporting

confidence: 85%

Sleep bruxism is associated to micro‐arousals and an increase in cardiac sympathetic activity

Huynh

Kato

Rompré

et al. 2006

Journal of Sleep Research

181

134

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“…On the opposite, from NREM to REM sleep a significant reduction in total HRV together with a shift of sympatho-vagal balance toward a vagal withdrawal and a possible sympathetic predominance has been reported (Berlad et al, 1993; Baharav et al, 1995; Versace et al, 2003). …”

Section: Heart Rate Variability In Wake/sleep Statesmentioning

confidence: 99%

Heart rate variability in normal and pathological sleep

Nobili²,

et al. 2013

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Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non-linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non-linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non-linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.

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“…However, it is not unreasonable to expect that correlates of the EEG-defined sleep stages can also be present in the ECG, primarily through autonomic modulation of cardiac activity. Indeed, previous studies have shown that the ECG contains relevant information about sleep stages [5,13,16,17,25,33]. In these studies, several ECG derived features (powers in the VLF, LF and HF spectral bands, and the LF/HF ratio) have been described which allow discrimination with various degrees of accuracy between sleep stages.…”

Section: Introductionmentioning

confidence: 99%