Analysis of Heart Rate Asymmetry During Sleep Stages

It is one of the hot spots in recent years to explore changes in the sleep stage by assessing autonomic nervous activity. In recent years, heart rate asymmetry (HRA) is often used to measure the activity of autonomic nerves. However, the relationship between HRA and sleep stage is not clear. We performed Porta’s index (PI), Guzik’s index (GI), slope index (SI) and area index (AI) analyses on RR intervals per 30-s for understanding the HRA during sleep. Two measurement protocols were set: 1) the HRA values were calculated; 2) the degrees of heart rate deviation from symmetry were estimated. Results showed that PI significantly decreased from N1 and N2 to N3 (p<0.01), and it is increased the highest in REM than other stages (p<0.05). The asymmetry of HRA were significantly lower in N3 (PI and AI p’s<0.05; GI and SI p’s<0.01), and it increased in REM (PI p<0.05; GI, SI and AI p’s<0.0001). The results suggested that HRA has the potential to be used in sleep stage monitoring.

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Sleep Stage Assessment Using Power Spectral Indices of Heart Rate Variability With a Simple Algorithm

Biological Research For Nursing ◽

10.1177/1099800412440498 ◽

2012 ◽

Vol 15 (3) ◽

pp. 264-272 ◽

Cited By ~ 12

Author(s):

Keiko Tanida ◽

Masashi Shibata ◽

Margaret M. Heitkemper

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sleep Stage ◽

Sleep Onset ◽

Low Frequency ◽

Simple Algorithm ◽

Sleep Stages ◽

Spectral Indices ◽

Current Form ◽

Power Spectral

Clinical researchers do not typically assess sleep with polysomnography (PSG) but rather with observation. However, methods relying on observation have limited reliability and are not suitable for assessing sleep depth and cycles. The purpose of this methodological study was to compare a sleep analysis method based on power spectral indices of heart rate variability (HRV) data to PSG. PSG and electrocardiography data were collected synchronously from 10 healthy women (ages 20–61 years) over 23 nights in a laboratory setting. HRV was analyzed for each 60-s epoch and calculated at 3 frequency band powers (very low frequency [VLF]-hi: 0.016–0.04 Hz; low frequency [LF]: 0.04–0.15 Hz; and high frequency [HF]: 0.15–0.4 Hz). Using HF/(VLF-hi + LF + HF) value, VLF-hi, and heart rate (HR) as indices, an algorithm to categorize sleep into 3 states (shallow sleep corresponding to Stages 1 & 2, deep sleep corresponding to Stages 3 & 4, and rapid eye movement [REM] sleep) was created. Movement epochs and time of sleep onset and wake-up were determined using VLF-hi and HR. The minute-by-minute agreement rate with the sleep stages as identified by PSG and HRV data ranged from 32 to 72% with an average of 56%. Longer wake after sleep onset (WASO) resulted in lower agreement rates. The mean differences between the 2 methods were 2 min for the time of sleep onset and 6 min for the time of wake-up. These results indicate that distinguishing WASO from shallow sleep segments is difficult using this HRV method. The algorithm's usefulness is thus limited in its current form, and it requires additional modification.

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Heart Rate Asymmetry Analysis Using Poincaré Plot

Poincaré Plot Methods for Heart Rate Variability Analysis ◽

10.1007/978-1-4614-7375-6_5 ◽

2013 ◽

pp. 69-91

Author(s):

Ahsan Habib Khandoker ◽

Chandan Karmakar ◽

Michael Brennan ◽

Andreas Voss ◽

Marimuthu Palaniswami

Keyword(s):

Heart Rate ◽

Poincaré Plot ◽

Asymmetry Analysis ◽

Rate Asymmetry ◽

Heart Rate Asymmetry

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Attention Deficit/Hyperactivity Disorder (ADHD) Is Associated With Altered Heart Rate Asymmetry

Physiological Research ◽

10.33549/physiolres.932919 ◽

2014 ◽

pp. S509-S519 ◽

Cited By ~ 2

Author(s):

I. TONHAJZEROVÁ ◽

I. ONDREJKA ◽

I. FARSKÝ ◽

Z. VIŠŇOVCOVÁ ◽

M. MEŠŤANÍK ◽

...

Keyword(s):

Heart Rate ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Physiological Stress ◽

Regulatory System ◽

Adverse Outcomes ◽

Time Asymmetry ◽

Hyperactivity Disorder ◽

Rate Asymmetry ◽

Heart Rate Asymmetry

Attention deficit/hyperactivity disorder (ADHD) is associated with complex neurocardiac integrity. We aimed to study heart rate time asymmetry as a nonlinear qualitative feature of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in children suffering from ADHD. Twenty boys with ADHD and 20 healthy age-matched boys at the age of 8 to 12 years were examined. The continuous ECG was recorded in a supine position and during postural change from lying to standing (orthostasis). Time irreversibility indices – Porta’s (P%), Guzik’s (G%) and Ehlers’ (E) – were evaluated. Our analysis showed significantly reduced heart rate asymmetry indices at rest (P%: 49.8 % vs. 52.2 %; G%: 50.2 % vs. 53.2 %; p<0.02), and in response to orthostatic load (P%: 52.4 % vs. 54.5 %, G%: 52.3 % vs. 54.5 %; p<0.05) associated with tachycardia in ADHD children compared to controls. Concluding, our study firstly revealed the altered heart rate asymmetry pattern in children suffering from ADHD at rest as well as in response to posture change from lying to standing (orthostasis). These findings might reflect an abnormal complex cardiac regulatory system as a potential mechanism leading to later cardiac adverse outcomes in ADHD.

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463 The Effect of Intervention of Medical Staff on the Adherence of CPAP and Heart Rate in Patients with Obstructive Sleep Apnea

SLEEP ◽

10.1093/sleep/zsab072.462 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A182-A183

Author(s):

Ryutaro Shirahama ◽

Rie Ishimaru ◽

Jun Takagiwa ◽

Yasue Mitsukura

Keyword(s):

Heart Rate ◽

Medical Staff ◽

Nervous Activity ◽

Sympathetic Nervous Activity ◽

Sleep Stages ◽

Obstructive Sleep ◽

Group A ◽

Group B ◽

Tele Monitoring ◽

Mean Heart Rate

Abstract Introduction Recent studies have indicated that obstructive sleep apnea syndrome (OSAS) is associated with hypertension. OSA is a common cause of sympathetic nervous activity. Increase of sympathetic nervous activity causes hypertension. Continuous positive airway pressure (CPAP) is the most useful treatment for OSAS. Good CPAP adherence treatment improve the risk of hypertension. This study examined the effect of intervention of medical staff on the adherence of CPAP, heart rate and sleep stages in patients with OSA. Methods All patients diagnosed with OSA and undergoing subsequent CPAP were clinically followed for 12 months to examine CPAP adherence, as well as longitudinal changes in blood pressure, average heartrate of 24 hours and sleep stages. They were divided into 2 groups, Group A: patients who had individual consulted in person by sleep physician and technicians before start using CPAP and Group B: patents who did not have individual consulted. Patients in both groups were consulted by sleep physician and technicians after start CPAP with utilizing tele-monitoring. If the adherence were poor, the patients were recommended to stop CPAP. We provided 3D accelerometer and an optical pulse photoplethysmography to all the patients and analyzed the data of heart rate and sleep stages. Results A total of 30 OSA patients underwent CPAP, were enrolled in the study and assessed for changes in mean heart rate and body weight during the study period. We found a significant reduction in mean heart rate in both group A and B compared with baseline (p<-0.05). The patients aged under 50 years old and whose AHI<20 times/hour have higher ratio of dropout CPAP therapy. There was no significant difference between Group A and Group B on the persistency rate of CPAP therapy. Also, no significant association was found between group A and B on the adherence of CPAP. Conclusion We showed the importance of the effect of intervention of medical staff on the adherence of CPAP and heart rate in patients with OSA the consultation after starting CPAP for a while with utilizing tele-monitoring data would be more effective compared with that in person before start using CPAP. Support (if any):

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