Circadian Variation of Heart Rate Variability Across Sleep Stages
Circadian Variation of Heart Rate Variability Across Sleep Stages
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DOI：
10.5665/sleep.3230
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发表时间：
2013-12-01
期刊：
影响因子：
5.6
通讯作者：
Boivin, Diane B.
中科院分区：
文献类型：
--
作者：
Boudreau, Philippe;Yeh, Wei-Hsien;Boivin, Diane B.
研究目的：夜间心血管事件在夜间开始和结束时更为频繁。有人提出，这种模式反映了睡眠和睡眠阶段的夜间分布。利用心率变异性（HRV），我们最近发现了昼夜节律系统和警惕状态之间在心律调节方面的相互作用。在这里，我们进一步研究这种相互作用，以澄清睡眠阶段对心脏调节的具体影响。设计：参与者在时间隔离中进行72小时的超昼夜睡眠-觉醒周期程序，包括在昏暗光线下交替觉醒60分钟，在完全黑暗中小睡60分钟。设置：时间隔离套件。患者或参与者：15名健康青年参与者；其中两人随后被排除在外。干预措施:N / A。测量和结果：目前的研究表明，睡眠的开始和进入更深的睡眠阶段与向更大的副交感神经调节转变有关，而快速眼动（REM）睡眠与向更大的交感神经调节转变有关。我们在清醒和所有非快速眼动睡眠阶段发现了心率（HR）和高频功率的昼夜节律。在快速眼动睡眠期间也观察到明显的心率昼夜节律和心脏交感迷走神经平衡。在慢波睡眠期间，副交感神经调节的最大时间出现在凌晨02:00左右，而在快速眼动睡眠期间，交感神经调节的最大时间出现在清晨。结论：昼夜节律和睡眠阶段特异性对心率变异性的影响具有临床相关性，有助于了解睡眠时心血管易损性的程度。
Study Objectives: Nocturnal cardiovascular events are more frequent at the beginning and end of the night. It was proposed that this pattern reflects the nocturnal distribution of sleep and sleep stages. Using heart rate variability (HRV), we recently showed an interaction between the circadian system and vigilance states on the regulation of cardiac rhythmicity. Here, we further investigate this interaction in order to clarify the specific effects of sleep stages on the regulation of the heart.Design: Participants underwent a 72-h ultradian sleep-wake cycle procedure in time isolation consisting of alternating 60-min wake episodes in dim light and 60-min nap opportunities in total darkness.Setting: Time isolation suite.Patients or participants: Fifteen healthy young participants; two were subsequently excluded.Interventions: N/A.Measurements and Results: The current study revealed that sleep onset and progression to deeper sleep stages was associated with a shift toward greater parasympathetic modulation, whereas rapid eye movement (REM) sleep was associated with a shift toward greater sympathetic modulation. We found a circadian rhythm of heart rate (HR) and high-frequency power during wakefulness and all non-REM sleep stages. A significant circadian rhythm of HR and sympathovagal balance of the heart was also observed during REM sleep. During slow wave sleep, maximal parasympathetic modulation was observed at similar to 02:00, whereas during REM sleep, maximal sympathetic modulation occurred in the early morning.Conclusion: The circadian and sleep stage-specific effects on heart rate variability are clinically relevant and contribute to the understanding of the degree of cardiovascular vulnerability during sleep.