Heart rate responses to non-arousing trigeminal stimulation in infants: Effects of sleep position, sleep state and postnatal age

The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants.

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249 Overnight heart rate variability depends on age, gender, and day of the week: a field observation using a smart bed platform

SLEEP ◽

10.1093/sleep/zsab072.248 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A100-A101

Author(s):

Shawn Barr ◽

Kwanghyun Sohn ◽

Gary Garcia

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Physiological Stress ◽

Large Population ◽

Population Level ◽

Large Set ◽

Sleep State ◽

Cross Sectional ◽

Day Of The Week ◽

Broad Interest

Abstract Introduction Heart rate variability (HRV) is commonly used to assess the activity of the autonomic nervous system (ANS). ANS function changes, reflected in HRV, result from factors including lifestyle, aging, cardiorespiratory illnesses, sleep state, and physiological stress. Despite broad interest in HRV, few studies have established normative overnight HRV values for a large population. To better understand population level HRV changes, ecologically-valid, overnight sleep SDNN (standard deviation of all normal heartbeat intervals, lower HRV is reflected by lower SDNN) values have been analyzed for a large sample of Sleep Number 360 smart bed users. Methods Overnight SDNN values were obtained over the course of 18.2M sleep sessions from 379,225 sleepers (48 ± 14.7 sessions/user). 50.9 percent of sleepers were female. The age was normally distributed with mean ± SD of 52.8 ± 12.7 years (range 21 to 84). Heartbeat intervals used to compute SDNN were extracted from a ballistocardiogram (BCG). BCG-based HRV estimation during sleep has previously been validated against ECG-based HRV with an R-square of 0.5. Results Using a Generalized Linear Model, significant cross-sectional associations with SDNN were observed for three variables of interest: age, gender, and day-of-the-week. For sleepers under 50, SDNN declined at a rate of about 2.1 ms/year, then leveled off for sleepers aged 50-65, and increased slightly thereafter. Women under 50 displayed lower, more slowly declining, SDNN values than men, but this trend reversed for sleepers over 50. Throughout the week, SDNN values followed a U-shaped (women) or L-shaped (men) pattern, where values were highest during the weekend and lowest at mid-week. Conclusion Using a smart bed to unobtrusively measure overnight SDNN values for a large set of sleepers in an ecologically valid environment, reveals significant effects of age, gender, and day of the week on overnight SDNN. Support (if any):

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Preoperative Heart Rate Variability During Sleep Predicts Vagus Nerve Stimulation Outcome Better in Patients With Drug-Resistant Epilepsy

Frontiers in Neurology ◽

10.3389/fneur.2021.691328 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xi Fang ◽

Hong-Yun Liu ◽

Zhi-Yan Wang ◽

Zhao Yang ◽

Tung-Yang Cheng ◽

...

Keyword(s):

Machine Learning ◽

Heart Rate ◽

Heart Rate Variability ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Outcome Prediction ◽

Healthy Controls ◽

Drug Resistant ◽

Sleep State ◽

Drug Resistant Epilepsy

Objective: Vagus nerve stimulation (VNS) is an adjunctive and well-established treatment for patients with drug-resistant epilepsy (DRE). However, it is still difficult to identify patients who may benefit from VNS surgery. Our study aims to propose a VNS outcome prediction model based on machine learning with multidimensional preoperative heart rate variability (HRV) indices.Methods: The preoperative electrocardiography (ECG) of 59 patients with DRE and of 50 healthy controls were analyzed. Responders were defined as having at least 50% average monthly seizure frequency reduction at 1-year follow-up. Time domain, frequency domain, and non-linear indices of HRV were compared between 30 responders and 29 non-responders in awake and sleep states, respectively. For feature selection, univariate filter and recursive feature elimination (RFE) algorithms were performed to assess the importance of different HRV indices to VNS outcome prediction and improve the classification performance. Random forest (RF) was used to train the classifier, and leave-one-out (LOO) cross-validation was performed to evaluate the prediction model.Results: Among 52 HRV indices, 49 showed significant differences between DRE patients and healthy controls. In sleep state, 35 HRV indices of responders were significantly higher than those of non-responders, while 16 of them showed the same differences in awake state. Low-frequency power (LF) ranked first in the importance ranking results by univariate filter and RFE methods, respectively. With HRV indices in sleep state, our model achieved 74.6% accuracy, 80% precision, 70.6% recall, and 75% F1 for VNS outcome prediction, which was better than the optimal performance in awake state (65.3% accuracy, 66.4% precision, 70.5% recall, and 68.4% F1).Significance: With the ECG during sleep state and machine learning techniques, the statistical model based on preoperative HRV could achieve a better performance of VNS outcome prediction and, therefore, help patients who are not suitable for VNS to avoid the high cost of surgery and possible risks of long-term stimulation.

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Neurocirculatory consequences of abrupt change in sleep state in humans

Journal of Applied Physiology ◽

10.1152/jappl.1996.80.5.1627 ◽

1996 ◽

Vol 80 (5) ◽

pp. 1627-1636 ◽

Cited By ~ 108

Author(s):

B. J. Morgan ◽

D. C. Crabtree ◽

D. S. Puleo ◽

M. S. Badr ◽

F. Toiber ◽

...

Keyword(s):

Heart Rate ◽

Arterial Pressure ◽

Pressor Response ◽

Muscle Sympathetic Nerve Activity ◽

Intrathoracic Pressure ◽

Nrem Sleep ◽

Auditory Stimuli ◽

Sleep State ◽

Healthy Humans ◽

Pressor Responses

The arterial pressure elevations that accompany sleep apneas may be caused by chemoreflex stimulation, negative intrathoracic pressure, and/or arousal. To assess the neurocirculatory effects of arousal alone, we applied graded auditory stimuli during non-rapid-eye-movement (NREM) sleep in eight healthy humans. We measured muscle sympathetic nerve activity (intraneural microelectrodes), electroencephalogram (EEG; C4/A1 and O1/A2), arterial pressure (photoelectric plethysmography), heart rate (electrocardiogram), and stroke volume (impedance cardiography). Auditory stimuli caused abrupt increases in systolic and diastolic pressures (21 +/- 2 and 15 +/- 1 mmHg) and heart rate (11 +/- 2 beats/min). Cardiac output decreased (-10%). Stimuli that produced EEG evidence of arousal evoked one to two large bursts of sympathetic activity (316 +/- 46% of baseline amplitude). Stimuli that did not alter EEG frequency produced smaller but consistent pressor responses even though no sympathetic activation was observed. We conclude that arousal from NREM sleep evokes a pressor response caused by increased peripheral vascular resistance. Increased sympathetic outflow to skeletal muscle may contribute to, but is not required for, this vasoconstriction. The neurocirculatory effects of arousal may augment those caused by asphyxia during episodes of sleep-disordered breathing.

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Unobtrusive assessment of neonatal sleep state based on heart rate variability retrieved from electrocardiography used for regular patient monitoring

Early Human Development ◽

10.1016/j.earlhumdev.2017.07.004 ◽

2017 ◽

Vol 113 ◽

pp. 104-113 ◽

Cited By ~ 7

Author(s):

Jan Werth ◽

Xi Long ◽

Elly Zwartkruis-Pelgrim ◽

Hendrik Niemarkt ◽

Wei Chen ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Patient Monitoring ◽

Sleep State

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Sleep state instabilities in patients with periodic limb movements in sleep - Detection and quantification with heart rate variability

Psychiatry Research ◽

10.1016/j.psychres.2020.113454 ◽

2020 ◽

Vol 293 ◽

pp. 113454

Author(s):

Chen-Yu Lin ◽

Shih-Jen Tsai ◽

Chung-Kang Peng ◽

Albert C. Yang

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Periodic Limb Movements ◽

Limb Movements ◽

Sleep State ◽

Detection And Quantification

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Postnatal maturation of laryngeal chemoreflexes in the preterm lamb

Journal of Applied Physiology ◽

10.1152/japplphysiol.00977.2006 ◽

2007 ◽

Vol 102 (4) ◽

pp. 1429-1438 ◽

Cited By ~ 29

Author(s):

Marie St-Hilaire ◽

Nathalie Samson ◽

Elise Nsegbe ◽

Charles Duvareille ◽

François Moreau-Bussière ◽

...

Keyword(s):

Heart Rate ◽

Lower Airway ◽

Distilled Water ◽

Active Sleep ◽

Sleep State ◽

Quiet Sleep ◽

General Belief ◽

Postnatal Maturation ◽

Laryngeal Mucosa ◽

Life Threatening

Laryngeal chemoreflexes (LCR) are triggered by the contact of liquids with the laryngeal mucosa. In the mature organism, LCR trigger lower airway protective responses (coughing, effective swallowing, and arousal) to prevent aspiration. General belief holds that LCR are responsible for apnea and bradycardia in the newborn mammal, including humans. Our laboratory has recently shown that LCR in full-term lambs are consistently analogous to the mature LCR reported in adult mammals, without significant apneas and bradycardias (St-Hilaire M, Nsegbe E, Gagnon-Gervais K, Samson N, Moreau-Bussiere F, Fortier PH, and Praud J-P. J Appl Physiol 98: 2197–2203, 2005). The aim of the present study was to assess LCR in nonsedated, newborn preterm lambs born at 132 days of gestation (term = 147 days). The preterm lambs were instrumented for recording glottal adductor electromyogram, electroencephalogram, eye movements, heart rate, respiration, and oximetry. A chronic supraglottal catheter was used for injecting 0.5 ml of saline, distilled water, and HCl (pH 2) during quiet sleep, active sleep, and wakefulness on postnatal days 7 (D7) and 14 (D14). Laryngeal stimulation by water or HCl on D7 induced significant apneas, bradycardia, and desaturation, which, at times, appeared potentially life-threatening. No significant apneas, bradycardias, or desaturation were observed on D14. No consistent effects of sleep state could be shown in the present study. In conclusion, laryngeal stimulation by liquids triggers potentially dangerous LCR in preterm lambs on D7, but not on D14. It is proposed that maturation of the LCR between D7 and D14 is partly involved in the disappearance of apneas/bradycardias of prematurity with postnatal age.

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Arousal responses of the newborn piglet to airways obstruction and rebreathing during normothermia and hyperthermia

Reproduction Fertility and Development ◽

10.1071/rd9960365 ◽

1996 ◽

Vol 8 (3) ◽

pp. 365 ◽

Cited By ~ 3

Author(s):

BC Galland ◽

NS Wehner ◽

DP Bolton ◽

BJ Taylor

Keyword(s):

Heart Rate ◽

Heat Stress ◽

Experimental Studies ◽

Thermal Conditions ◽

Nrem Sleep ◽

Sleep State ◽

Adverse Conditions ◽

Airways Obstruction ◽

Respiratory Variables ◽

Thermal States

Most experimental studies of arousal to respiratory stressors have been performed under neutral thermal conditions. The present study focussed on arousal responses with the added challenge of heat stress. The subjects were two groups of 10 sedated piglets aged 4-6 days and 2-6 days respectively. Respiratory stimuli (partial and total airways obstruction (AO) or rebreathing (RB) expired gases) were applied during non-rapid-eye-movement (NREM) sleep. Measurements of heart rate, SaO2, intra-pleural pressure or inspired CO2 and O2 were recorded during tests in normothermia and hyperthermia. Hyperthermia significantly shortened the time to arousal. Thus, arousal times from partial and total AO and from RB were: in normothermia, 40.3 +/- 5.8, 9.2 +/- 0.7 and 94.9 +/- 14.7 s respectively; in hyperthermia, 17.8 +/- 3.7, 7.6 +/- 0.9 and 68.5 +/- 9.1 s respectively. Cardio-respiratory variables at arousal were similar in both thermal states. Seven non-sedated piglets were challenged with RB stimuli during normothermia only to determine the influence of sleep state on arousal. Arousal in REM sleep was delayed approximately 2-3-fold (NREM, 41.2 +/- 8.2 s; REM, 88.5 +/- 18.1 s), occurring at a lower SaO2 and higher inspired CO2. It is concluded that arousal from NREM sleep under adverse conditions of hyperthermia shortens the arousal time from asphyxial stimuli induced by AO and RB with no change in the arousal threshold.

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