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Cheng Y, Huang P, Lin L, Zhang J, Cheng Y, Zheng J, Wang Y, Pan X. Abnormal brain-heart electrophysiology in mild and severe orthostatic hypotension. J Hypertens 2024:00004872-990000000-00532. [PMID: 39207017 DOI: 10.1097/hjh.0000000000003838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
INTRODUCTION This study investigated the changes in cardiocerebral electrophysiology in patients with mild orthostatic hypotension (MOH) and severe orthostatic hypotension (SOH) and their relationship with the severity of orthostatic hypotension, psychiatric symptoms, and cognitive dysfunction. METHODS This study included 72 nonorthostatic hypotension (NOH), 17 with MOH, and 11 with SOH. Seated resting-state heart rate variability (HRV) and quantitative electroencephalogram parameters were synchronized and recorded. HRV measures in the time and frequency domains were analyzed, along with the peak frequency and power of the brain waves. RESULTS Abnormal neuronal activity was found in FP1 in patients with MOH, whereas it was more widespread in FP1, FP2, and O2 in patients with SOH (P < 0.05). Cardiac and cerebral electrophysiological abnormalities were significantly associated with orthostatic hypotension severity, psychiatric symptoms, and cognitive dysfunction. CONCLUSION Abnormal EEG activity in patients are mainly manifested in the prefrontal and occipital lobes, especially in patients with SOH. These results may help patients to better understand the mechanisms underlying orthostatic hypotension severity and psychiatric and cognitive impairment in orthostatic hypotension.
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Affiliation(s)
- Yingzhe Cheng
- Department of Neurology, Center for Cognitive Neurology
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital
- Institute of Clinical Neurology
- Four Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou City
| | - Peilin Huang
- Department of Neurology, Center for Cognitive Neurology
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital
- Institute of Clinical Neurology
- Four Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou City
| | - Lin Lin
- Department of Neurology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jiejun Zhang
- Department of Neurology, Center for Cognitive Neurology
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital
- Institute of Clinical Neurology
- Four Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou City
- Center for Geriatrics, Hainan General Hospital, Hainan Province
| | - Yahui Cheng
- Shandong Second Medical University, Weifang City
| | - Jiahao Zheng
- Department of Neurology, Center for Cognitive Neurology
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital
- Institute of Clinical Neurology
- Four Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou City
| | - Yanping Wang
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou
| | - Xiaodong Pan
- Department of Neurology, Center for Cognitive Neurology
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital
- Institute of Clinical Neurology
- Four Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou City
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Yeh CH, Chen CY, Kuo YE, Chen CW, Kuo TBJ, Kuo KL, Chen HM, Huang HY, Chern CM, Yang CCH. Role of the autonomic nervous system in young, middle-aged, and older individuals with essential hypertension and sleep-related changes in neurocardiac regulation. Sci Rep 2023; 13:22623. [PMID: 38114517 PMCID: PMC10730708 DOI: 10.1038/s41598-023-49649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
Essential hypertension involves complex cardiovascular regulation. The autonomic nervous system function fluctuates throughout the sleep-wake cycle and changes with advancing age. However, the precise role of the autonomic nervous system in the development of hypertension during aging remains unclear. In this study, we characterized autonomic function during the sleep-wake cycle in different age groups with essential hypertension. This study included 97 men (53 with and 44 without hypertension) aged 30-79 years. They were stratified by age into young (< 40 years), middle-aged (40-59 years), and older (60-79 years) groups. Polysomnography and blood pressure data were recorded for 2 min before and during an hour-long nap. Autonomic function was assessed by measuring heart rate variability and blood pressure variability. Data were analyzed using t tests, correlation analyses, and two-way analysis of variance. During nonrapid eye movement (nREM), a main effect of age was observed on cardiac parasympathetic measures and baroreflex sensitivity (BRS), with the highest and lowest levels noted in the younger and older groups, respectively. The coefficients of the correlations between these measures and age were lower in patients with hypertension than in normotensive controls. The BRS of young patients with hypertension was similar to that of their middle-aged and older counterparts. However, cardiac sympathetic activity was significantly higher (p = 0.023) and BRS was significantly lower (p = 0.022) in the hypertension group than in the control group. During wakefulness, the results were similar although some of the above findings were absent. Autonomic imbalance, particularly impaired baroreflex, plays a more significant role in younger patients with hypertension. The nREM stage may be suitable for gaining insights into the relevant mechanisms.
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Affiliation(s)
- Chia-Hsin Yeh
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Yu Chen
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-En Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chieh-Wen Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Clinical Research Center, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Mind and Brain Medicine, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hong-Ming Chen
- Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Yi Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan.
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
- Department of Neurology, En Chu Kong (ECK) Hospital, 399 Fu-Xing Road, Sanxia District, New Taipei City, 23702, Taiwan.
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Beitou, Taipei, 11221, Taiwan.
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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Effects of age and sex on vasomotor activity and baroreflex sensitivity during the sleep-wake cycle. Sci Rep 2022; 12:22424. [PMID: 36575245 PMCID: PMC9794808 DOI: 10.1038/s41598-022-26440-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular function is related to age, sex, and state of consciousness. We hypothesized that cardiovagal baroreflex sensitivity (BRS) demonstrates different patterns in both sexes before and after 50 years of age and that these patterns are associated with patterned changes during the sleep-wake cycle. We recruited 67 healthy participants (aged 20-79 years; 41 women) and divided them into four age groups: 20-29, 30-49, 50-69, and 70-79 years. All the participants underwent polysomnography and blood pressure measurements. For each participant, we used the average of the arterial pressure variability, heart rate variability (HRV), and BRS parameters during the sleep-wake stages. BRS and HRV parameters were significantly negatively correlated with age. The BRS indexes were significantly lower in the participants aged ≥ 50 years than in those aged < 50 years, and these age-related declines were more apparent during non-rapid eye movement sleep than during wakefulness. Only BRS demonstrated a significantly negative correlation with age in participants ≥ 50 years old. Women exhibited a stronger association than men between BRS and age and an earlier decline in BRS. Changes in BRS varied with age, sex, and consciousness state, each demonstrating a specific pattern. The age of 50 years appeared to be a crucial turning point for sexual dimorphism in BRS. Baroreflex modulation of the cardiovascular system during sleep sensitively delineated the age- and sex-dependent BRS patterns, highlighting the clinical importance of our results. Our findings may aid in screening for neurocardiac abnormalities in apparently healthy individuals.
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Chang KS, Chiu YH, Kao WF, Yang CCH, How CK, Lin YK, Hwang YS, Chien DK, Huang MK, Kuo TBJ. The changes of electroencephalography in mountaineers on Mount Jade, Taiwan: An observational study. PLoS One 2022; 17:e0275870. [PMID: 36417369 PMCID: PMC9683632 DOI: 10.1371/journal.pone.0275870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The diagnosis of acute mountain sickness, which lacks a reliable and objective diagnostic tool, still depends on the clinical symptoms and signs and remains a major threat and unpredictable disease affecting millions of mountaineers. OBJECTIVES To record electroencephalography signals with small, convenient, wireless equipment and to test whether electroencephalography parameters, which are more sensitive and reliable markers, could predict the symptoms of acute mountain sickness. METHODS Twenty-five participants were enrolled and separated into two groups to climb Mount Jade in Taiwan. We collected electrocardiography signals and arterial oxygen saturation data at ground, moderate (2,400 m), and high altitude (3,400 m). A spectral analysis of the electrocardiography was performed to assess the study subjects' electroencephalography activity at different frequencies (α, β, θ, δ) and the mean power frequency of electrocardiography. The clinical symptoms and Lake Louise Acute Mountain Sickness scores of the subjects were recorded for comparison. RESULTS A significant change in the δ power of electroencephalography was recorded in subjects ascending from the ground to a high altitude of 3,400 m in a 4-day itinerary. In addition, between the two groups of subjects with and without acute mountain sickness (Lake Louise Acute Mountain Sickness scores < 3 and ≥ 3), the δ power of electroencephalography at the fronto-parietal 1 and parietal 3 electrodes at moderate altitude as well as the changes of δ power and mean power frequency of electrocardiography over parietal 4 at high altitude showed a significant difference. At moderate altitude, the increasing δ power of electroencephalography at the parietal 4 electrode was related to the headache symptom of acute mountain sickness before ascending to high altitude. CONCLUSION At moderate altitude, the δ power increase of electroencephalography at the P4 electrode could be a predictor of acute mountain sickness symptoms before ascending to high altitude. Thus, electroencephalography had the potential to identify the risk of acute mountain sickness.
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Affiliation(s)
- Kuo-Song Chang
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Yu-Hui Chiu
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Fong Kao
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Emergency and Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Chorng-Kuang How
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yuh-Shyan Hwang
- Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Ding-Kuo Chien
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Ming-Kun Huang
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan
- * E-mail: (MKH); (TBJK)
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sleep Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Clinical Research Center, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- * E-mail: (MKH); (TBJK)
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Chen PC, Zhang J, Thayer JF, Mednick SC. Understanding the roles of central and autonomic activity during sleep in the improvement of working memory and episodic memory. Proc Natl Acad Sci U S A 2022; 119:e2123417119. [PMID: 36279428 PMCID: PMC9636982 DOI: 10.1073/pnas.2123417119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The last decade has seen significant progress in identifying sleep mechanisms that support cognition. Most of these studies focus on the link between electrophysiological events of the central nervous system during sleep and improvements in different cognitive domains, while the dynamic shifts of the autonomic nervous system across sleep have been largely overlooked. Recent studies, however, have identified significant contributions of autonomic inputs during sleep to cognition. Yet, there remain considerable gaps in understanding how central and autonomic systems work together during sleep to facilitate cognitive improvement. In this article we examine the evidence for the independent and interactive roles of central and autonomic activities during sleep and wake in cognitive processing. We specifically focus on the prefrontal-subcortical structures supporting working memory and mechanisms underlying the formation of hippocampal-dependent episodic memory. Our Slow Oscillation Switch Model identifies separate and competing underlying mechanisms supporting the two memory domains at the synaptic, systems, and behavioral levels. We propose that sleep is a competitive arena in which both memory domains vie for limited resources, experimentally demonstrated when boosting one system leads to a functional trade-off in electrophysiological and behavioral outcomes. As these findings inevitably lead to further questions, we suggest areas of future research to better understand how the brain and body interact to support a wide range of cognitive domains during a single sleep episode.
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Affiliation(s)
- Pin-Chun Chen
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104
| | - Jing Zhang
- Department of Cognitive Sciences, University of California, Irvine, CA 92697
| | - Julian F. Thayer
- Department of Psychological Sciences, University of California, Irvine, CA 92697
| | - Sara C. Mednick
- Department of Cognitive Sciences, University of California, Irvine, CA 92697
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6
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Autonomic Central Coupling during Daytime Sleep Differs between Older and Younger People. Neurobiol Learn Mem 2022; 193:107646. [PMID: 35671980 DOI: 10.1016/j.nlm.2022.107646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 04/12/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022]
Abstract
Decreased functioning in the elderly is mirrored by independent changes in central and autonomic nervous systems. Additionally, recent work suggests that the coupling of these systems may also serve an important role. In young adults, Autonomic and Central Events (ACEs), measured in the temporal coincidence of heart rate bursts (HRBs) and increased slow-wave-activity (SWA, 0.5-1Hz) and sigma activity (12-15Hz), followed by parasympathetic surge (RRHF) during non-rapid eye movement (NREM) sleep, predicted cognitive improvements. However, ACEs have not been examined in the elderly. Thus, the current study compared ACEs during wake and daytime sleep in older and younger adults and examined associations with working memory improvement before and after a nap. Compared to youngers, older adults showed lower amplitude of ACEs during NREM sleep, but not during wake. Furthermore, while younger adults demonstrated a parasympathetic surge after HRBs, older adults showed an earlier rise and longer maintenance of the RRHF. Taken together, our results demonstrate that autonomic-central coupling declines with age. Pathological aging implicates independent roles for decreased autonomic and central nervous system functioning, the current findings suggest that the coupling of these systems may also deserve attention.
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Tsai HJ, Yang AC, Tsai SJ, Ma Y, Kuo TBJ, Yang CCH, Peng CK. Associations of Reduced Sympathetic Neural Activity and Elevated Baroreflex Sensitivity With Non-Rapid Eye Movement Sleep: Evidence From Electroencephalogram- and Electrocardiogram-Based Sleep Staging. Psychosom Med 2022; 84:621-631. [PMID: 35420584 DOI: 10.1097/psy.0000000000001079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Autonomic neural controls in sleep regulation have been previously demonstrated; however, whether these alternations can be observed by different sleep staging approaches remains unclear. Two established methods for sleep staging-the standardized visual scoring and the cardiopulmonary coupling (CPC) analysis based on electrocardiogram-were used to explore the cardiovascular profiles of sleep. METHODS Overnight polysomnography was recorded together with continuous beat-to-beat blood pressure. Cortical activity, heart rate variability, blood pressure variability, and baroreflex sensitivity during sleep stages from 24 nights of sleep were obtained from 15 normotensive participants and analyzed. RESULTS Non-rapid eye movement sleep (NREM) from visual scoring and restful sleep (RS) of CPC both showed the highest delta power of electroencephalogram (EEG) and lowest beta activity of EEG in comparison with other sleep stages (p < .001); likewise, the lowest total power of heart rate variability and suppressed vascular-sympathetic activity, reflected by low-frequency power of blood pressure variability, as well as a trend in elevated baroreflex sensitivity, were observed in the NREM or RS. This suppressed vascular-sympathetic activity during stable sleep further exhibited a significant correlation with increased slow-wave activity (NREM: r = -0.292 ± 0.34, p = .002; RS: r = -0.209 ± 0.30, p = .010). CONCLUSIONS Autonomic nervous system is evidently associated with stable sleep, as indicated by the similar findings obtained from sleep stages categorized by standardized visual scoring or CPC analysis. Such association between cardiovascular neural activity and sleep EEGs can be observed regardless of the sleep staging approach followed.
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Affiliation(s)
- Hsin-Jung Tsai
- From the Department of Psychiatry (H.-J. Tsai, S.-J. Tsai), Taipei Veterans General Hospital; Institute of Brain Science (H.-J. Tsai, A.C. Yang, S.-J. Tsai, Kuo, C.C.H. Yang), National Yang Ming Chiao Tung University, Digital Medicine Center (A.C. Yang), National Yang Ming Chiao Tung University; Department of Medical Research (A.C. Yang), Taipei Veterans General Hospital, Taipei, Taiwan; Osher Center for Integrative Medicine (Ma), Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School; Center for Dynamical Biomarkers (Ma, Peng), Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts; Clinical Research Center (Kuo), Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan; and Sleep Research Center (H.-J. Tsai, Kuo, C.C.H. Yang), National Yang Ming Chiao Tung University, Taipei, Taiwan
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Eddie D, Bentley KH, Bernard R, Mischoulon D, Winkelman JW. Aggregating heart rate variability indices across sleep stage epochs ignores significant variance through the night. Sleep Med 2022; 90:262-266. [PMID: 35228137 PMCID: PMC8923916 DOI: 10.1016/j.sleep.2021.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/08/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Heart rate variability (HRV) is a widely utilized biomarker of autonomic regulatory functioning, and concomitant health and pathological states. A growing body of work is exploring HRV under sleeping conditions. Most of this literature utilizes either averaged HRV indices calculated from multiple sleep stage epochs, or averaged HRV throughout the night. Both approaches implicitly assume that HRV within sleep epoch types is consistent throughout the night. Given the robust literature indicating the existence of an endogenous cardiovascular circadian rhythm as well as the potential for effects for cumulative time asleep, we hypothesized that HRV would vary across distinct sleep epochs. METHODS Participants underwent at least one night of home polysomnography that included electroencephalogram, electromyogram, and electrocardiogram (N = 73). All rapid eye movement (REM) and non-REM stage 2 (N2) sleep epochs with a duration greater than or equal to 5 min were identified for HRV analysis. Time and frequency domain indices of HRV were calculated for each sleep stage epoch. Linear mixed models were used to examine main effects of time on HRV indices for N2 and REM sleeps epochs respectively. RESULTS Main effects of time were observed for all models. Patterns emerged for both the N2 and REM epochs, suggesting HRV indices are non-stationary (ie variable) across distinct sleep epochs through the course of the night. CONCLUSIONS The present findings indicate HRV is non-stationary across sleep stage epochs. Aggregating HRV indices across sleep stage epochs likely obscures important transient effects and increases risk of type-I and type-II errors.
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Affiliation(s)
- David Eddie
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA.
| | - Kate H Bentley
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - Richard Bernard
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
| | - John W Winkelman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA
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Ebrahimi F, Alizadeh I. Automatic sleep staging by cardiorespiratory signals: a systematic review. Sleep Breath 2021; 26:965-981. [PMID: 34322822 DOI: 10.1007/s11325-021-02435-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Because of problems with the recording and analysis of the EEG signal, automatic sleep staging using cardiorespiratory signals has been employed as an alternative. This study reports on certain critical points which hold considerable promise for the improvement of the results of the automatic sleep staging using cardiorespiratory signals. METHODS A systematic review. RESULTS The review and analysis of the literature in this area revealed four outstanding points: (1) the feature extraction epoch length, denoting that the standard 30-s segments of cardiorespiratory signals do not carry enough information for automatic sleep staging and that a 4.5-min length segment centering on each 30-s segment is proper for staging, (2) the time delay between the EEG signal extracted from the central nervous system activity and the cardiorespiratory signals extracted from the autonomic nervous system activity should be considered in the automatic sleep staging using cardiorespiratory signals, (3) the information in the morphology of ECG signals can contribute to the improvement of sleep staging, and (4) applying convolutional neural network (CNN) and long short-term memory network (LSTM) deep structures simultaneously to a large PSG recording database can lead to more reliable automatic sleep staging results. CONCLUSIONS Considering the above-mentioned points simultaneously can improve automatic sleep staging by cardiorespiratory signals. It is hoped that by considering the points, staging sleep automatically using cardiorespiratory signals, which does not have problems with the recording and analysis of EEG signals, yields results acceptably close to the results of automatic sleep staging by EEG signals.
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Affiliation(s)
- Farideh Ebrahimi
- Faculty of Electrical and Computer Engineering, Babol Noshirvani University of Technology, Babol, Mazandaran, Iran.
| | - Iman Alizadeh
- English Language Department, School of Paramedical Sciences, Guilan University of Medical Sciences, Rasht, Iran
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Qin H, Steenbergen N, Glos M, Wessel N, Kraemer JF, Vaquerizo-Villar F, Penzel T. The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea. Front Psychiatry 2021; 12:642333. [PMID: 34366907 PMCID: PMC8339263 DOI: 10.3389/fpsyt.2021.642333] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/14/2021] [Indexed: 12/15/2022] Open
Abstract
Obstructive sleep apnea (OSA), a heterogeneous and multifactorial sleep related breathing disorder with high prevalence, is a recognized risk factor for cardiovascular morbidity and mortality. Autonomic dysfunction leads to adverse cardiovascular outcomes in diverse pathways. Heart rate is a complex physiological process involving neurovisceral networks and relative regulatory mechanisms such as thermoregulation, renin-angiotensin-aldosterone mechanisms, and metabolic mechanisms. Heart rate variability (HRV) is considered as a reliable and non-invasive measure of autonomic modulation response and adaptation to endogenous and exogenous stimuli. HRV measures may add a new dimension to help understand the interplay between cardiac and nervous system involvement in OSA. The aim of this review is to introduce the various applications of HRV in different aspects of OSA to examine the impaired neuro-cardiac modulation. More specifically, the topics covered include: HRV time windows, sleep staging, arousal, sleepiness, hypoxia, mental illness, and mortality and morbidity. All of these aspects show pathways in the clinical implementation of HRV to screen, diagnose, classify, and predict patients as a reasonable and more convenient alternative to current measures.
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Affiliation(s)
- Hua Qin
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Martin Glos
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Niels Wessel
- Department of Physics, Humboldt Universität zu Berlin, Berlin, Germany
| | - Jan F. Kraemer
- Department of Physics, Humboldt Universität zu Berlin, Berlin, Germany
| | - Fernando Vaquerizo-Villar
- Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red-Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Saratov State University, Russian Federation, Saratov, Russia
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Nowara EM, McDuff D, Veeraraghavan A. Systematic analysis of video-based pulse measurement from compressed videos. BIOMEDICAL OPTICS EXPRESS 2021; 12:494-508. [PMID: 33659085 PMCID: PMC7899506 DOI: 10.1364/boe.408471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/12/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
Camera-based physiological measurement enables vital signs to be captured unobtrusively without contact with the body. Remote, or imaging, photoplethysmography involves recovering peripheral blood flow from subtle variations in video pixel intensities. While the pulse signal might be easy to obtain from high quality uncompressed videos, the signal-to-noise ratio drops dramatically with video bitrate. Uncompressed videos incur large file storage and data transfer costs, making analysis, manipulation and sharing challenging. To help address these challenges, we use compression specific supervised models to mitigate the effect of temporal video compression on heart rate estimates. We perform a systematic evaluation of the performance of state-of-the-art algorithms across different levels, and formats, of compression. We demonstrate that networks trained on compressed videos consistently outperform other benchmark methods, both on stationary videos and videos with significant rigid head motions. By training on videos with the same, or higher compression factor than test videos, we achieve improvements in signal-to-noise ratio (SNR) of up to 3 dB and mean absolute error (MAE) of up to 6 beats per minute (BPM).
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Affiliation(s)
- Ewa M. Nowara
- Electrical and Computer Engineering Department, Rice University, 6100 Main St, Houston, TX 77005, USA
| | - Daniel McDuff
- Microsoft Research AI, 14820 NE 36th St, Redmond, WA 98052, USA
| | - Ashok Veeraraghavan
- Electrical and Computer Engineering Department, Rice University, 6100 Main St, Houston, TX 77005, USA
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12
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Wood C, Bianchi MT, Yun CH, Shin C, Thomas RJ. Multicomponent Analysis of Sleep Using Electrocortical, Respiratory, Autonomic and Hemodynamic Signals Reveals Distinct Features of Stable and Unstable NREM and REM Sleep. Front Physiol 2020; 11:592978. [PMID: 33343390 PMCID: PMC7744633 DOI: 10.3389/fphys.2020.592978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022] Open
Abstract
A new concept of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep is proposed, that of multi-component integrative states that define stable and unstable sleep, respectively, NREMS, NREMUS REMS, and REMUS. Three complementary data sets are used: obstructive sleep apnea (20), healthy subjects (11), and high loop gain sleep apnea (50). We use polysomnography (PSG) with beat-to-beat blood pressure monitoring, and electrocardiogram (ECG)-derived cardiopulmonary coupling (CPC) analysis to demonstrate a bimodal, rather than graded, characteristic of NREM sleep. Stable NREM (NREMS) is characterized by high probability of occurrence of the <1 Hz slow oscillation, high delta power, stable breathing, blood pressure dipping, strong sinus arrhythmia and vagal dominance, and high frequency CPC. Conversely, unstable NREM (NREMUS) has the opposite features: a fragmented and discontinuous <1 Hz slow oscillation, non-dipping of blood pressure, unstable respiration, cyclic variation in heart rate, and low frequency CPC. The dimension of NREM stability raises the possibility of a comprehensive integrated multicomponent network model of NREM sleep which captures sleep onset (e.g., ventrolateral preoptic area-based sleep switch) processes, synaptic homeostatic delta power kinetics, and the interaction of global and local sleep processes as reflected in the spatiotemporal evolution of cortical “UP” and “DOWN” states, while incorporating the complex dynamics of autonomic-respiratory-hemodynamic systems during sleep. Bimodality of REM sleep is harder to discern in health. However, individuals with combined obstructive and central sleep apnea allows ready recognition of REMS and REMUS (stable and unstable REM sleep, respectively), especially when there is a discordance of respiratory patterns in relation to conventional stage of sleep.
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Affiliation(s)
- Christopher Wood
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Matt Travis Bianchi
- Division of Sleep Medicine, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chol Shin
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Robert Joseph Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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13
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Abstract
Neural oscillations play an important role in the integration and segregation of brain regions that are important for brain functions, including pain. Disturbances in oscillatory activity are associated with several disease states, including chronic pain. Studies of neural oscillations related to pain have identified several functional bands, especially alpha, beta, and gamma bands, implicated in nociceptive processing. In this review, we introduce several properties of neural oscillations that are important to understand the role of brain oscillations in nociceptive processing. We also discuss the role of neural oscillations in the maintenance of efficient communication in the brain. Finally, we discuss the role of neural oscillations in healthy and chronic pain nociceptive processing. These data and concepts illustrate the key role of regional and interregional neural oscillations in nociceptive processing underlying acute and chronic pains.
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Affiliation(s)
- Junseok A. Kim
- Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen D. Davis
- Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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14
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Fantozzi MPT, Artoni F, Faraguna U. Heart rate variability at bedtime predicts subsequent sleep features. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:6784-6788. [PMID: 31947398 DOI: 10.1109/embc.2019.8857844] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Getting enough sleep during the night is important for preventing adverse short- and long-term health outcomes. The sympathetic-parasympathetic autonomic balance, characteristics of the pre-bed time resting period, correlates with sleep efficiency. We investigated in healthy subjects whether Low/High Frequencies (LF/HF) and other Heart Rate Variability (HRV) metrics, extracted in the period immediately before sleep onset, are able to predict quality/architecture sleep parameters in the sample group and in the Evening-Intermediate- chronotype subgroups. Linear correlations were found between HRV metrics and the investigated quality/architecture sleep parameters. The possibility to predict sleep parameters from the HRV metrics while falling asleep might pave the way to behavioral interventions during the bedtime period to increase the quality of sleep.
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15
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Chen PC, Whitehurst LN, Naji M, Mednick SC. Autonomic/central coupling benefits working memory in healthy young adults. Neurobiol Learn Mem 2020; 173:107267. [PMID: 32535198 DOI: 10.1016/j.nlm.2020.107267] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/13/2020] [Accepted: 06/08/2020] [Indexed: 02/01/2023]
Abstract
Working memory (WM) is an executive function that can improve with training. However, the precise mechanism for this improvement is not known. Studies have shown greater WM gains after a period of sleep than a similar period of wake, and correlations between WM improvement and slow wave activity (SWA; 0.5-1 Hz) during slow wave sleep (SWS). A different body of literature has suggested an important role for autonomic activity during wake for WM. A recent study from our group reported that the temporal coupling of Autonomic/CentralEvents (ACEs) during sleep was associated with memory consolidation. We found that heart rate bursts (HR bursts) during non-rapid eye movement (NREM) sleep are accompanied by increases in SWA and sigma (12-15 Hz) power, as well as increases in the high-frequency (HF) component of the RR interval, reflecting vagal rebound. In addition, ACEs predict long-term, episodic memory improvement. Building on these previous results, we examined whether ACEs also contribute to gains in WM. We tested 104 young adults in an operation span task (OSPAN) in the morning and evening, with either a nap (n = 53; with electroencephalography (EEG) and electrocardiography (ECG)) or wake (n = 51) between testing sessions. We identified HR bursts in the ECG and replicated the increases in SWA and sigma prior to peak of the HR burst, as well as vagal rebound after the peak. Furthermore, we showed sleep-dependent WM improvement, which was predicted by ACE activity. Using regression analyses, we discovered that significantly more variance in WM improvement could be explained with ACE variables than with overall sleep activity not time-locked with ECG. These results provide the first evidence that coordinated autonomic and central events play a significant role in sleep-related WM improvement and implicate the potential of autonomic interventions during sleep for cognitive enhancement.
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Affiliation(s)
- Pin-Chun Chen
- Department of Cognitive Science, University of California, Irvine USA
| | | | - Mohsen Naji
- Department of Medicine, University of California, San Diego, CA, USA
| | - Sara C Mednick
- Department of Cognitive Science, University of California, Irvine USA.
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16
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Willoughby AR, de Zambotti M, Baker FC, Colrain IM. Evoked K-complexes and altered interaction between the central and autonomic nervous systems during sleep in alcohol use disorder. Alcohol 2020; 84:1-7. [PMID: 31539623 PMCID: PMC10005844 DOI: 10.1016/j.alcohol.2019.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 12/11/2022]
Abstract
There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS responses (impairment in CNS-ANS coupling), we assessed phasic heart rate (HR) fluctuation associated with tones that did and those that did not elicit a K-complex (KC) during stable N2 non-rapid eye movement (NREM) sleep in a group of 16 recently abstinent alcohol use disorder (AUD) patients (41.6 ± 8.5 years) and a group of 13 sex- and age-matched control participants (46.6 ± 9.3 years). Electroencephalogram (EEG) and electrocardiogram (ECG) data were recorded throughout the night. Alcohol consumption questionnaires were also administered to the AUD patients. AUD patients had elevated HR compared to controls at baseline prior to tone presentation. The HR fluctuation associated with KCs elicited by tone presentation was significantly smaller in amplitude, and tended to be delayed in time, in the AUD group compared with the control group, and the subsequent deceleration was also smaller in AUD patients. In both groups, the increase in HR was larger and occurred earlier when KCs were produced than when they were not, and there was no difference in the magnitude of the KC effect between groups. Phasic HR changes associated with KCs elicited by tones are impaired in AUD participants, reflecting ANS dysfunction possibly caused by an alteration of cardiac vagal trafficking. However, only the timing of the HR response was found to relate to estimated lifetime alcohol consumption in AUD. The clinical meaning and implications of these novel findings need to be determined.
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Affiliation(s)
- Adrian R Willoughby
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; School of Psychology and Clinical Language Sciences, University of Reading Malaysia, Johor, Malaysia
| | | | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
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Orjuela-Cañón AD, Cerquera A, Freund JA, Juliá-Serdá G, Ravelo-García AG. Sleep apnea: Tracking effects of a first session of CPAP therapy by means of Granger causality. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 187:105235. [PMID: 31812116 DOI: 10.1016/j.cmpb.2019.105235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/04/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
Connectivity between physiological networks is an issue of particular importance for understanding the complex interaction brain-heart. In the present study, this interaction was analyzed in polysomnography recordings of 28 patients diagnosed with obstructive sleep apnea (OSA) and compared with a group of 10 control subjects. Electroencephalography and electrocardiography signals from these polysomnography time series were characterized employing Granger causality computation to measure the directed connectivity among five brain waves and three spectral subbands of heart rate variability. Polysomnography data from OSA patients were recorded before and during a first session of continuous positive air pressure (CPAP) therapy in a split-night study. Results showed that CPAP therapy allowed the recovery of inner brain connectivities, mainly in subsystems involving the theta wave. In addition, differences between control and OSA patients were established in connections that involve lower frequency ranges of heart rate variability. This information can be potentially useful in the initial diagnosis of OSA, and determine the role of cardiac activity in sleep dynamics based on the use of three subbands of heart rate variability.
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Affiliation(s)
- Alvaro D Orjuela-Cañón
- Facultad de Ingeniería Mecánica, Electrónica y Biomédica, Universidad Antonio Nariño, Bogotá D.C., Colombia; Biomedical Engineering Program, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C., Colombia.
| | - Alexander Cerquera
- Brain Dynamics Program, Wilder Center for Epilepsy Research. Department of Neurology-College of Medicine. University of Florida, Gainesville, FL, United States.
| | - Jan A Freund
- Carl von Ossietzky Universität Oldenburg. ICBM & Research Center Neurosensory Science. D-26111, Oldenburg, Germany.
| | - Gabriel Juliá-Serdá
- Pulmonary Medicine Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria 35010, Spain.
| | - Antonio G Ravelo-García
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria 35017, Spain.
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18
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Walter LM, Tamanyan K, Weichard AJ, Biggs SN, Davey MJ, Nixon GM, Horne RSC. Age and autonomic control, but not cerebral oxygenation, are significant determinants of EEG spectral power in children. Sleep 2019; 42:5513436. [DOI: 10.1093/sleep/zsz118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/05/2019] [Indexed: 01/28/2023] Open
Abstract
AbstractStudy ObjectivesSleep disordered breathing (SDB) in children has significant effects on daytime functioning and cardiovascular control; attributed to sleep fragmentation and repetitive hypoxia. Associations between electroencephalograph (EEG) spectral power, autonomic cardiovascular control and cerebral oxygenation have been identified in adults with SDB. To date, there have been no studies in children. We aimed to assess associations between EEG spectral power and heart rate variability as a measure of autonomic control, with cerebral oxygenation in children with SDB.MethodsOne hundred sixteen children (3–12 years) with SDB and 42 controls underwent overnight polysomnography including measurement of cerebral oxygenation. Power spectral analysis of the EEG derived from C4-M1 and F4-M1, quantified delta, theta, alpha, and beta waveforms during sleep. Multiple regression tested whether age, SDB severity, heart rate (HR), HR variability (HRV), and cerebral oxygenation were determinants of EEG spectral power.ResultsThere were no differences in EEG spectral power derived from either central or frontal regions for any frequency between children with different severities of SDB so these were combined. Age, HR, and HRV low frequency power were significant determinants of EEG spectral power depending on brain region and sleep stage.ConclusionThe significant findings of this study were that age and autonomic control, rather than cerebral oxygenation and SDB severity, were predictive of EEG spectral power in children. Further research is needed to elucidate how the physiology that underlies the relationship between autonomic control and EEG impacts on the cardiovascular sequelae in children with SDB.
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Affiliation(s)
- Lisa M Walter
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Knarik Tamanyan
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Aidan J Weichard
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Sarah N Biggs
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Margot J Davey
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Melbourne, Australia
| | - Gillian M Nixon
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Melbourne, Australia
| | - Rosemary S C Horne
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
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19
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Nakayama N, Hayashi T, Miyachi M, Negi K, Watanabe K, Hirai M. Napping Improves HRV in Older Patients With Cardiovascular Risk Factors. West J Nurs Res 2019; 41:1241-1253. [PMID: 30632455 DOI: 10.1177/0193945918824603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Heart rate variability (HRV), especially increased high frequency (HF), has been reported to provide clinically useful prognostic information regarding cardiovascular disease. Napping is an excellent sleep management strategy in older adults. This study was conducted to clarify the effect of napping on HRV in older adult patients with cardiovascular risk factors. The patients were divided into two groups: one group of 32 patients who reported napping (nap group) and another group of 45 patients who did not report napping (nonnap group). The HRV was calculated in terms of the HF component over 24 hr during wakefulness, sleep, and 1 hr after sleep onset. The HF in the nap group was significantly higher than that in the nonnap group during all times measured. In addition, napping was a significant predictor of increased HF. This study shows the effectiveness of napping in the daily lives of patients with cardiovascular risk factors.
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20
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De Pascalis V, Scacchia P. The influence of reward sensitivity, heart rate dynamics and EEG-delta activity on placebo analgesia. Behav Brain Res 2018; 359:320-332. [PMID: 30439452 DOI: 10.1016/j.bbr.2018.11.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/10/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023]
Abstract
Personality traits have been shown to interact with environmental cues to modulate biological responses including treatment responses, and potentially having a role in the formation of placebo effects. Here we used the Reinforcement Sensitivity Theory Personality Questionnaire (RST-PQ) to identify personality traits that predict placebo analgesic responding. Cardiac inter-beat (RR) time series and electroencephalographic (EEG) band oscillations were recorded from healthy women in a cold-pain (Pain) and placebo analgesia (PA) condition. The measures of Hypnotizability, and self-reported ratings of Hypnotic Depth, Motivation, Pain Expectation, Involuntariness in PA responding, Pain and Distress intensity were obtained. Separate principal components factor analyses with varimax rotation were performed on summarized heart rate variability (HRV) measures of time, frequency, nonlinear Complexity, and EEG-band activity. Both analyses yielded a similar three-factor solution including Frequency HRV (factor-1), Complexity HRV dynamics (factor-2), and time HRV & EEG-delta activity (factor-3). Reward Interest sub-trait of the Behavioral Approach System (BAS-RI), Pain Expectation, Involuntariness in PA responding, and Hypnotic Depth were positively associated, whereas negative changes in time-HRV & EEG-delta scores were associated with Pain Reduction. Multiple mediation analyses disclosed that BAS-RI, potentially served by the dopaminergic system, through Involuntariness in PA responding can alter placebo responding to laboratory pain. Our results also show that a linear compound of HR slowing and higher EEG delta activity during PA explains a substantial proportion of the variance in placebo analgesic responses. Future studies should examine the potential role that these individual difference measures may play in patient responsiveness to treatments for clinical pain.
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Affiliation(s)
- V De Pascalis
- Department of Psychology "La Sapienza" University of Rome, Italy.
| | - P Scacchia
- Department of Psychology "La Sapienza" University of Rome, Italy
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21
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de Zambotti M, Trinder J, Silvani A, Colrain IM, Baker FC. Dynamic coupling between the central and autonomic nervous systems during sleep: A review. Neurosci Biobehav Rev 2018; 90:84-103. [PMID: 29608990 PMCID: PMC5993613 DOI: 10.1016/j.neubiorev.2018.03.027] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/16/2018] [Accepted: 03/24/2018] [Indexed: 12/19/2022]
Abstract
Sleep is characterized by coordinated cortical and cardiac oscillations reflecting communication between the central (CNS) and autonomic (ANS) nervous systems. Here, we review fluctuations in ANS activity in association with CNS-defined sleep stages and cycles, and with phasic cortical events during sleep (e.g., arousals, K-complexes). Recent novel analytic methods reveal a dynamic organization of integrated physiological networks during sleep and indicate how multiple factors (e.g., sleep structure, age, sleep disorders) affect "CNS-ANS coupling". However, these data are mostly correlational and there is a lack of clarity of the underlying physiology, making it challenging to interpret causality and direction of coupling. Experimental manipulations (e.g., evoking K-complexes or arousals) provide information on the precise temporal sequence of cortical-cardiac activity, and are useful for investigating physiological pathways underlying CNS-ANS coupling. With the emergence of new analytical approaches and a renewed interest in ANS and CNS communication during sleep, future work may reveal novel insights into sleep and cardiovascular interactions during health and disease, in which coupling could be adversely impacted.
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Affiliation(s)
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
| | - Alessandro Silvani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
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22
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Altered nocturnal blood pressure profiles in women with insomnia disorder in the menopausal transition. Menopause 2018; 24:278-287. [PMID: 27749736 DOI: 10.1097/gme.0000000000000754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Insomnia disorder is a risk factor for cardiovascular (CV) pathology. It is unknown whether insomnia that develops in the context of the menopausal transition (MT) impacts the CV system. We assessed nocturnal blood pressure (BP) and heart rate (HR) profiles in women with insomnia disorder in the MT. METHODS Twelve women meeting DSM-IV criteria for insomnia in the MT (age, mean ± SD: 50.5 ± 3.6 y) and 11 controls (age, mean ± SD: 49.0 ± 3.0 y) had polysomnographic recordings on one or two nights during which beat-to-beat BP and HR were assessed and analyzed hourly from lights-out across the first 6 hours of the night and according to sleep stage. Physiological hot flashes were identified from fluctuations in sternal skin conductance. RESULTS Women with insomnia and controls had similar distributions of sleep stages and awakenings/arousals across hours of the night, although insomnia participants tended to have more wakefulness overall. More women in the insomnia group (7 of 12) than in the control group (2 of 11) had at least one physiological hot flash at night (P < 0.05). Both groups showed a drop in BP in the first part of the night; however, systolic and diastolic BP patterns diverged later, remaining low in controls but increasing in insomnia participants 4 to 6 hours after lights-out (P < 0.05). Both groups showed a similar pattern of decline in HR across the night. CONCLUSIONS Our findings suggest altered regulatory control of BP during sleep in the MT insomnia. The causes and long-term consequences of this altered nocturnal BP profile remain to be determined.
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Satpute AB, Kragel PA, Barrett LF, Wager TD, Bianciardi M. Deconstructing arousal into wakeful, autonomic and affective varieties. Neurosci Lett 2018; 693:19-28. [PMID: 29378297 DOI: 10.1016/j.neulet.2018.01.042] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 01/13/2018] [Accepted: 01/22/2018] [Indexed: 12/11/2022]
Abstract
Arousal plays a central role in a wide variety of phenomena, including wakefulness, autonomic function, affect and emotion. Despite its importance, it remains unclear as to how the neural mechanisms for arousal are organized across them. In this article, we review neuroscience findings for three of the most common origins of arousal: wakeful arousal, autonomic arousal, and affective arousal. Our review makes two overarching points. First, research conducted primarily in non-human animals underscores the importance of several subcortical nuclei that contribute to various sources of arousal, motivating the need for an integrative framework. Thus, we outline an integrative neural reference space as a key first step in developing a more systematic understanding of central nervous system contributions to arousal. Second, there is a translational gap between research on non-human animals, which emphasizes subcortical nuclei, and research on humans using non-invasive neuroimaging techniques, which focuses more on gross anatomical characterizations of cortical (e.g. network architectures including the default mode network) and subcortical structures. We forecast the importance of high-field neuroimaging in bridging this gap to examine how the various networks within the neural reference space for arousal operate across varieties of arousal-related phenomena.
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Affiliation(s)
- Ajay B Satpute
- Departments of Psychology and Neuroscience, Pomona College, Claremont, CA, USA; Department of Psychology, Northeastern University, Boston, MA, USA.
| | - Philip A Kragel
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; The Institute of Cognitive Science, University of Colorado Boulder, Boulder, USA
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Tor D Wager
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; The Institute of Cognitive Science, University of Colorado Boulder, Boulder, USA
| | - Marta Bianciardi
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA.
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Huang G, Yang X, Huang J. Morning surge in blood pressure and sympathetic activity in Mongolians and Han Chinese: a multimodality investigation of hypertension and dyssomnia. PeerJ 2017; 5:e3758. [PMID: 28948098 PMCID: PMC5609520 DOI: 10.7717/peerj.3758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/13/2017] [Indexed: 11/20/2022] Open
Abstract
Background Hypertension and dyssomnia are increasing significantly in Mongolians, and the related factors of ethnic differences in hypertension and dyssomnia between Mongolians and Han Chinese are unclear. This study examined the relationship of morning surge in blood pressure (MBP) with ethnicity, sleep situation, and sympathetic activity throughout the day. Methods Of 692 hypertensive patients screened, 202 subjects with dyssomnia were selected. They were then divided into Mongolian (n = 87) and Han (n = 115) groups. The differences in dyssomnia, 24-h blood pressure, and urinary catecholamine were analyzed in all subjects; they were then further divided according to the degree of dyssomnia (low, moderate, and severe) to determine the differences in blood pressure and catecholamine. Results Mongolians had a lower history of smoking, daytime dysfunction, nocturnal heart rates, and dopamine levels, but their body mass index, triglyceride, fasting glucose, morning surge in systolic blood pressure (MSBP), nocturnal systolic blood pressure (NSBP), nocturnal diastolic blood pressure, daytime systolic blood pressure, daytime heart rates, and dopamine level (D-DA) were higher than those of Han Chinese. With the aggravation of dyssomnia, MSBP, NSBP, D-NE, daytime epinephrine, and D-DA of Mongolians and Han Chinese increased gradually, but the rate of increase was faster in the latter (p < 0.05). D-DA was entered into the MSBP regression model of Mongolians (intercept, 157 mmHg), whereas D-DA and D-NE were entered into the MSBP regression model of Han Chinese (intercept, 142 mmHg). Conclusion Worsened dyssomnia induces higher MSBP and augments sympathetic excitability in Mongolians and Han Chinese. Mongolians with hypertension and dyssomnia had higher MSBP baseline and D-DA but lower N-DA. With an increase in D-DA, MSBP in Han and Mongolian patients increased gradually.
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Affiliation(s)
- Guanhua Huang
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoming Yang
- Department of Cardiology, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Jing Huang
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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25
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Beach PA, Huck JT, Zhu DC, Bozoki AC. Altered Behavioral and Autonomic Pain Responses in Alzheimer's Disease Are Associated with Dysfunctional Affective, Self-Reflective and Salience Network Resting-State Connectivity. Front Aging Neurosci 2017; 9:297. [PMID: 28959201 PMCID: PMC5603705 DOI: 10.3389/fnagi.2017.00297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 08/30/2017] [Indexed: 12/25/2022] Open
Abstract
While pain behaviors are increased in Alzheimer's disease (AD) patients compared to healthy seniors (HS) across multiple disease stages, autonomic responses are reduced with advancing AD. To better understand the neural mechanisms underlying these phenomena, we undertook a controlled cross-sectional study examining behavioral (Pain Assessment in Advanced Dementia, PAINAD scores) and autonomic (heart rate, HR) pain responses in 24 HS and 20 AD subjects using acute pressure stimuli. Resting-state fMRI was utilized to investigate how group connectivity differences were related to altered pain responses. Pain behaviors (slope of PAINAD score change and mean PAINAD score) were increased in patients vs. CONTROLS Autonomic measures (HR change intercept and mean HR change) were reduced in severe vs. mildly affected AD patients. Group functional connectivity differences associated with greater pain behavior reactivity in patients included: connectivity within a temporal limbic network (TLN) and between the TLN and ventromedial prefrontal cortex (vmPFC); between default mode network (DMN) subcomponents; between the DMN and ventral salience network (vSN). Reduced HR responses within the AD group were associated with connectivity changes within the DMN and vSN-specifically the precuneus and vmPFC. Discriminant classification indicated HR-related connectivity within the vSN to the vmPFC best distinguished AD severity. Thus, altered behavioral and autonomic pain responses in AD reflects dysfunction of networks and structures subserving affective, self-reflective, salience and autonomic regulation.
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Affiliation(s)
- Paul A Beach
- D.O., Ph.D. Training Program, Michigan State University College of Osteopathic MedicineEast Lansing, MI, United States.,Neuroscience Program, Michigan State UniversityEast Lansing, MI, United States
| | - Jonathan T Huck
- Neuroscience Program, Michigan State UniversityEast Lansing, MI, United States
| | - David C Zhu
- Neuroscience Program, Michigan State UniversityEast Lansing, MI, United States.,Department of Radiology, Michigan State UniversityEast Lansing, MI, United States.,Department of Psychology, Michigan State UniversityEast Lansing, MI, United States
| | - Andrea C Bozoki
- Neuroscience Program, Michigan State UniversityEast Lansing, MI, United States.,Department of Neurology & Ophthalmology, Michigan State UniversityEast Lansing, MI, United States
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26
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Kuo TBJ, Lai CT, Chen CY, Yang YC, Yang CCH. The high-frequency component of heart rate variability during extended wakefulness is closely associated with the depth of the ensuing sleep in C57BL6 mice. Neuroscience 2016; 330:257-66. [PMID: 27267244 DOI: 10.1016/j.neuroscience.2016.05.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/28/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Abstract
This study aimed to test the hypothesis that, during extended wakefulness, parasympathetic activity is associated with the depth of the subsequent recovery sleep in mice. Fourteen male C57BL/6 mice were implanted with electrodes for sleep recording. Continuous spectral analysis was performed on the electroencephalogram (EEG) to obtain theta power (6-9Hz) and delta power (0-4Hz), as well as the R-R interval signals in order to quantify the high-frequency power (HF) and normalized low-frequency power (LF%) that are used to assess parasympathetic and sympathetic activity, respectively. All animals underwent a sleep deprivation experiment and a control experiment (6-h intervention and 1-h recovery period) on two separate days. During sleep deprivation, HF and theta power during wakefulness were significantly higher than during the control wakefulness after the second hour and first hour, respectively. During recovery non-rapid eye movement sleep, there was a rebound in sleep time and delta power as well as an elevation in HF relative to control post-intervention sleep. Both the rise in HF and theta power during extended wakefulness were found to be positively correlated with the delta power rebound. Furthermore, the HF change during extended wakefulness was also correlated with the amount of sleep loss and the enhancement of waking theta power. Our finding suggests that waking parasympathetic activity intimately reflects the cumulative sleep pressure, suggesting a potential role to be an autonomic marker for sleep propensity.
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Affiliation(s)
- T B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Research Center for Adaptive Data Analysis, National Central University, Taoyuan, Taiwan
| | - C T Lai
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - C Y Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Neurological institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Y C Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - C C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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27
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Faes L, Marinazzo D, Stramaglia S, Jurysta F, Porta A, Giandomenico N. Predictability decomposition detects the impairment of brain-heart dynamical networks during sleep disorders and their recovery with treatment. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2016; 374:rsta.2015.0177. [PMID: 27044993 PMCID: PMC4822440 DOI: 10.1098/rsta.2015.0177] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2016] [Indexed: 05/03/2023]
Abstract
This work introduces a framework to study the network formed by the autonomic component of heart rate variability (cardiac processη) and the amplitude of the different electroencephalographic waves (brain processes δ, θ, α, σ, β) during sleep. The framework exploits multivariate linear models to decompose the predictability of any given target process into measures of self-, causal and interaction predictability reflecting respectively the information retained in the process and related to its physiological complexity, the information transferred from the other source processes, and the information modified during the transfer according to redundant or synergistic interaction between the sources. The framework is here applied to theη,δ,θ,α,σ,βtime series measured from the sleep recordings of eight severe sleep apnoea-hypopnoea syndrome (SAHS) patients studied before and after long-term treatment with continuous positive airway pressure (CPAP) therapy, and 14 healthy controls. Results show that the full and self-predictability of η, δ and θ decreased significantly in SAHS compared with controls, and were restored with CPAP forδandθbut not forη The causal predictability of η and δ occurred through significantly redundant source interaction during healthy sleep, which was lost in SAHS and recovered after CPAP. These results indicate that predictability analysis is a viable tool to assess the modifications of complexity and causality of the cerebral and cardiac processes induced by sleep disorders, and to monitor the restoration of the neuroautonomic control of these processes during long-term treatment.
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Affiliation(s)
- Luca Faes
- Biotech, Department of Industrial Engineering, University of Trento, Trento, Italy IRCS Program, PAT-FBK Trento, Italy
| | | | - Sebastiano Stramaglia
- Department of Physics, University of Bari, Bari, Italy INFN Sezione di Bari, Bari, Italy
| | - Fabrice Jurysta
- Sleep Laboratory, Department of Psychiatry, ULB-Erasme Academic Hospital, Brussels, Belgium
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Nollo Giandomenico
- Biotech, Department of Industrial Engineering, University of Trento, Trento, Italy IRCS Program, PAT-FBK Trento, Italy
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de Zambotti M, Willoughby AR, Franzen PL, Clark DB, Baker FC, Colrain IM. K-Complexes: Interaction between the Central and Autonomic Nervous Systems during Sleep. Sleep 2016; 39:1129-37. [PMID: 26856907 DOI: 10.5665/sleep.5770] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 12/23/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To investigate the relationship between K-complexes (KCs) and cardiac functioning. METHODS Forty healthy adolescents aged 16-22 y (19 females) participated in the study. Heart rate (HR) fluctuations associated with spontaneous and evoked KCs were investigated on two nights, one with (event-related potential night) and one without auditory tones presented across the night. RESULTS There was a clear biphasic cardiac response to evoked and spontaneous KCs, with an initial acceleration in HR followed by a deceleration (P < 0.001). HR acceleration occurred immediately to KCs in response to tones presented in the first third of the interbeat interval, but was delayed a beat when the tone occurred later in the cardiac cycle (P < 0.05). Sex differences were also evident. Pretone baseline HR was higher, and the magnitude of the HR response was blunted and delayed, in female compared to male adolescents (P < 0.001). Also, pretone baseline HR was lower when a tone elicited a KC compared to when it did not (P < 0.001), suggesting that KCs are possibly more likely to be elicited by external stimuli in states of reduced cardiac activation. CONCLUSIONS The strict dependency observed between KCs and cardiac control indicates a potential role of KCs in modulating the cardiovascular system during sleep. Sex differences in the KC-cardiac response indicate the sensitivity of this measure in capturing sex differences in cardiac regulatory physiology.
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Affiliation(s)
| | | | | | - Duncan B Clark
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA.,Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
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29
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Hong CH, Kuo TBJ, Huang BC, Lin YC, Kuo KL, Chern CM, Yang CCH. Cold Exposure Can Induce an Exaggerated Early-Morning Blood Pressure Surge in Young Prehypertensives. PLoS One 2016; 11:e0150136. [PMID: 26919177 PMCID: PMC4769082 DOI: 10.1371/journal.pone.0150136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/09/2016] [Indexed: 11/19/2022] Open
Abstract
Prehypertension is related to a higher risk of cardiovascular events than normotension. Our previous study reported that cold exposure elevates the amplitude of the morning blood pressure surge (MBPS) and is associated with a sympathetic increase during the final sleep transition, which might be critical for sleep-related cardiovascular events in normotensives. However, few studies have explored the effects of cold exposure on autonomic function during sleep transitions and changes of autonomic function among prehypertensives. Therefore, we conducted an experiment for testing the effects of cold exposure on changes of autonomic function during sleep and the MBPS among young prehypertensives are more exaggerate than among young normotensives. The study groups consisted of 12 normotensive and 12 prehypertensive male adults with mean ages of 23.67 ± 0.70 and 25.25 ± 0.76 years, respectively. The subjects underwent cold (16°C) and warm (23°C) conditions randomly. The room temperature was maintained at either 23°C or 16°C by central air conditioning and recorded by a heat-sensitive sensor placed on the forehead and extended into the air. BP was measured every 30 minutes by using an autonomic BP monitor. Electroencephalograms, electrooculograms, electromyograms, electrocardiograms, and near body temperature were recorded by miniature polysomnography. Under cold exposure, a significantly higher amplitude of MBPS than under the warm condition among normotensives; however, this change was more exaggerated in prehypertensives. Furthermore, there was a significant decrease in parasympathetic-related RR and HF during the final sleep transition and a higher early-morning surge in BP and in LF% among prehypertensives, but no such change was found in normotensives. Our study supports that cold exposure might increase the risk of sleep-related cardiovascular events in prehypertensives.
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Affiliation(s)
- Cian-Hui Hong
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan
| | - Bo-Chi Huang
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Cheng Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- * E-mail:
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30
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Kuo TBJ, Li JY, Kuo HK, Chern CM, Yang CCH. Differential changes and interactions of autonomic functioning and sleep architecture before and after 50 years of age. AGE (DORDRECHT, NETHERLANDS) 2016; 38:5. [PMID: 26728397 PMCID: PMC5005895 DOI: 10.1007/s11357-015-9863-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/07/2015] [Indexed: 06/05/2023]
Abstract
We hypothesize that the time when age-related changes in autonomic functioning and in sleep structure occur are different and that autonomic functioning modulates sleep architecture differently before and after 50 years of age. Sixty-eight healthy subjects (aged 20 to 79 years old, 49 of them women) were enrolled. Correlation analysis revealed that wake after sleep onset, the absolute and relative value of stage 1 (S1; S1%), and relative value of stage 2 (S2) were positively correlated with age; however, sleep efficiency, stage 3 (S3), S3%, and rapid-eye-movement latency (REML) were negatively correlated with age. Significant degenerations of sleep during normal aging were occurred after 50 years of age; however, significant declines of autonomic activity were showed before 50 years of age. Before 50 years of age, vagal function during sleep was negatively correlated with arousal index; however, after 50 years of age, it was positively correlated with S1 and S1%. In addition, sympathetic activity during wake stage was positively related to S2% only after 50 years of age. Our results imply that the age-related changes in autonomic functioning decline promptly as individuals leave the younger part of their adult life span and that age-related changes in sleep slowly develop as individuals enter the older part of their adult life span. Furthermore, while various aspects of sleep architecture are modulated by both the sympathetic and vagal nervous systems during adult life span, the sleep quality is mainly correlated with the sympathetic division after 50 years of age.
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Affiliation(s)
- T B J Kuo
- Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Division of Translational Medicine, Stroke & Neurovascular Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jia-Yi Li
- Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Hsu-Ko Kuo
- Department of Geriatrics and Gerontology and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Division of Translational Medicine, Stroke & Neurovascular Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - C C H Yang
- Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan.
- Sleep Research Center, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
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31
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Lin YC, Lin YH, Lo MT, Peng CK, Huang NE, Yang CCH, Kuo TBJ. Novel application of multi dynamic trend analysis as a sensitive tool for detecting the effects of aging and congestive heart failure on heart rate variability. CHAOS (WOODBURY, N.Y.) 2016; 26:023109. [PMID: 26931590 DOI: 10.1063/1.4941673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The complex fluctuations in heart rate variability (HRV) reflect cardiac autonomic modulation and are an indicator of congestive heart failure (CHF). This paper proposes a novel nonlinear approach to HRV investigation, the multi dynamic trend analysis (MDTA) method, based on the empirical mode decomposition algorithm of the Hilbert-Huang transform combined with a variable-sized sliding-window method. Electrocardiographic signal data obtained from the PhysioNet database were used. These data were from subjects with CHF (mean age = 59.4 ± 8.4), an age-matched elderly healthy control group (59.3 ± 10.6), and a healthy young group (30.3 ± 4.8); the HRVs of these subjects were processed using the MDTA method, time domain analysis, and frequency domain analysis. Among all HRV parameters, the MDTA absolute value slope (MDTS) and MDTA deviation (MDTD) exhibited the greatest area under the curve (AUC) of the receiver operating characteristics in distinguishing between the CHF group and the healthy controls (AUC = 1.000) and between the healthy elderly subject group and the young subject group (AUC = 0.834 ± 0.067 for MDTS; 0.837 ± 0.066 for MDTD). The CHF subjects presented with lower MDTA indices than those of the healthy elderly subject group. Furthermore, the healthy elderly subjects exhibited lower MDTA indices than those of the young controls. The MDTA method can adaptively and automatically identify the intrinsic fluctuation on variable temporal and spatial scales when investigating complex fluctuations in the cardiac autonomic regulation effects of aging and CHF.
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Affiliation(s)
- Yu-Cheng Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Hsuan Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Men-Tzung Lo
- Center for Dynamical Biomarkers and Translational Medicine, National Central University, Jhongli, Taiwan
| | - Chung-Kang Peng
- Center for Dynamical Biomarkers and Translational Medicine, National Central University, Jhongli, Taiwan
| | - Norden E Huang
- Research Center for Adaptive Data Analysis, National Central University, Taoyuan, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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The association between prolonged sleep onset latency and heart rate dynamics among young sleep-onset insomniacs and good sleepers. Psychiatry Res 2015; 230:892-8. [PMID: 26616304 DOI: 10.1016/j.psychres.2015.11.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/04/2015] [Accepted: 11/18/2015] [Indexed: 11/23/2022]
Abstract
A blunting of heart rate (HR) reduction during sleep has been reported to be associated with increased all-cause mortality. An increased incident of cardiovascular events has been observed in patients with insomnia but the relationship between nighttime HR and insomnia remains unclear. Here we investigated the HR patterns during the sleep onset period and its association with the length of sleep onset latency (SOL). Nineteen sleep-onset insomniacs (SOI) and 14 good sleepers had their sleep analyzed. Linear regression and nonlinear Hilbert-Huang transform (HHT) of the HR slope were performed in order to analyze HR dynamics during the sleep onset period. A significant depression in HR fluctuation was identified among the SOI group during the sleep onset period when linear regression and HHT analysis were applied. The magnitude of the HR reduction was associated with both polysomnography-defined and subjective SOL; moreover, we found that the linear regression and HHT slopes of the HR showed great sensitivity with respect to sleep quality. Our findings indicate that HR dynamics during the sleep onset period are sensitive to sleep initiation difficulty and respond to the SOL, which indicates that the presence of autonomic dysfunction would seem to affect the progress of falling asleep.
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33
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Chen CL, Tang JS, Li PC, Chou PL. Immediate Effects of Smoking on Cardiorespiratory Responses During Dynamic Exercise: Arm Vs. Leg Ergometry. Front Physiol 2015; 6:376. [PMID: 26696905 PMCID: PMC4674552 DOI: 10.3389/fphys.2015.00376] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022] Open
Abstract
Purpose: This study compared the immediate effects of smoking on cardiorespiratory responses to dynamic arm and leg exercises. Methods:This randomized crossover study recruited 14 college students. Each participant underwent two sets of arm-cranking (AC) and leg-cycling (LC) exercise tests. The testing sequences of the control trial (participants refrained from smoking for 8 h before testing) and the experimental trial (participants smoked two cigarettes immediately before testing) were randomly chosen. We observed immediate changes in pulmonary function and heart rate variability after smoking and before the exercise test. The participants then underwent graded exercise tests of their arms and legs until reaching exhaustion. We compared the peak work achieved and time to exhaustion during the exercise tests with various cardiorespiratory indices [i.e., heart rate, oxygen consumption (VO2), minute ventilation (VE)]. The differences between the smoking and control trials were calculated using paired t-tests. For the exercise test periods, VO2, heart rate, and VE values were calculated at every 10% increment of the maximal effort time. The main effects of the time and trial, as well as their trial-by-time (4 × 10) interaction effects on the outcome measures, were investigated using repeated measure ANOVA with trend analysis. Results: 5 min after smoking, the participants exhibited reduced forced vital capacities and forced expiratory volumes in the first second (P < 0.05), in addition to elevated resting heart rates (P < 0.001). The high-frequency, low-frequency, and the total power of the heart rate variability were also reduced (P < 0.05) at rest. For the exercise test periods, smoking reduced the time to exhaustion (P = 0.005) and the ventilatory threshold (P < 0.05) in the LC tests, whereas no significant effects were observed in the AC tests. A trend analysis revealed a significant trial-by-time interaction effect for heart rate, VO2, and VE during the graded exercise test (all P < 0.001). Lower VO2 and VE levels were exhibited in the exercise response of the smoking trial than in those of the control LC trials, whereas no discernable inter-trial difference was observed in the AC trials. Moreover, the differences in heart rate and VE response between the LC and AC exercises were significantly smaller after the participants smoked. Conclusion: This study verified that smoking significantly decreased performance and cardiorespiratory responses to leg exercises. However, the negative effects of smoking on arm exercise performance were not as pronounced.
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Affiliation(s)
- Chien-Liang Chen
- Department of Physical Therapy, I-Shou University Kaohsiung, Taiwan
| | - Jing-Shia Tang
- Department of Nursing, Chung-Hwa University of Medical Technology Tainan, Taiwan ; Institute of Allied Health Sciences, National Cheng Kung University Tainan, Taiwan
| | - Ping-Chia Li
- Department of Occupational Therapy, I-Shou University Kaohsiung, Taiwan
| | - Pi-Ling Chou
- School of Nursing, Kaohsiung Medical University Kaohsiung, Taiwan
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Kuo TBJ, Chen CY, Hsu YC, Yang CCH. EEG beta power and heart rate variability describe the association between cortical and autonomic arousals across sleep. Auton Neurosci 2015; 194:32-7. [PMID: 26681575 DOI: 10.1016/j.autneu.2015.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 10/17/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022]
Abstract
Cortical and autonomic arousals have been found to be closely associated. As arousal events are not evenly dispersed across sleep, we hypothesized the relationship between high frequency electroencephalogram (EEG) power and autonomic arousal indices differ between non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. One night of polysomnographic recording was performed on a group of 18 subjects using a portable recorder. The EEG was collected from C3/Fz. Sleep stages and cortical arousals were visually scored. Cardiac autonomic modulation was assessed from heart rate variability, where the high frequency power (HF) indicates parasympathetic modulation, and the low frequency to high frequency power ratio (LF/HF) represents sympathetic modulation. During NREM sleep, EEG beta power was significantly correlated with LF/HF (r=0.40 ± 0.06), and the relationships were more positive than during REM sleep (LF/HF: r=0.20 ± 0.08; EOG power: r=-0.13 ± 0.05). The relationship of beta power with LF/HF was associated with the incidence of cortical arousal, particularly during NREM sleep. With respect to alpha power, it was only marginally related to HF or LF/HF. In addition, the coefficients of determination were lower for alpha power than for beta power in terms of the relationships to HF, LF/HF and EOG power. This study shows a higher relationship between cortical and autonomic activation during NREM sleep, and the association is better described by beta power. This finding suggests NREM sleep may be of greater therapeutic potential in view of reducing cardiovascular disease associated with sleep fragmentation, and beta power may provide a better index to evaluate the effect.
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Affiliation(s)
- Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan
| | - Chun-Yu Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Chuan Hsu
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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Rothenberger SD, Krafty RT, Taylor BJ, Cribbet MR, Thayer JF, Buysse DJ, Kravitz HM, Buysse ED, Hall MH. Time-varying correlations between delta EEG power and heart rate variability in midlife women: the SWAN Sleep Study. Psychophysiology 2015; 52:572-84. [PMID: 25431173 PMCID: PMC4376638 DOI: 10.1111/psyp.12383] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 09/25/2014] [Indexed: 11/30/2022]
Abstract
No studies have evaluated the dynamic, time-varying relationship between delta electroencephalographic (EEG) sleep and high frequency heart rate variability (HF-HRV) in women. Delta EEG and HF-HRV were measured during sleep in 197 midlife women (M(age) = 52.1, SD = 2.2). Delta EEG-HF-HRV correlations in nonrapid eye movement (NREM) sleep were modeled as whole-night averages and as continuous functions of time. The whole-night delta EEG-HF-HRV correlation was positive. The strongest correlations were observed during the first NREM sleep period preceding and following peak delta power. Time-varying correlations between delta EEG-HF-HRV were stronger in participants with sleep-disordered breathing and self-reported insomnia compared to healthy controls. The dynamic interplay between sleep and autonomic activity can be modeled across the night to examine within- and between-participant differences including individuals with and without sleep disorders.
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Affiliation(s)
- Scott D Rothenberger
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Faes L, Marinazzo D, Jurysta F, Nollo G. Linear and non-linear brain–heart and brain–brain interactions during sleep. Physiol Meas 2015; 36:683-98. [DOI: 10.1088/0967-3334/36/4/683] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Faes L, Kugiumtzis D, Nollo G, Jurysta F, Marinazzo D. Estimating the decomposition of predictive information in multivariate systems. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2015; 91:032904. [PMID: 25871169 DOI: 10.1103/physreve.91.032904] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Indexed: 05/04/2023]
Abstract
In the study of complex systems from observed multivariate time series, insight into the evolution of one system may be under investigation, which can be explained by the information storage of the system and the information transfer from other interacting systems. We present a framework for the model-free estimation of information storage and information transfer computed as the terms composing the predictive information about the target of a multivariate dynamical process. The approach tackles the curse of dimensionality employing a nonuniform embedding scheme that selects progressively, among the past components of the multivariate process, only those that contribute most, in terms of conditional mutual information, to the present target process. Moreover, it computes all information-theoretic quantities using a nearest-neighbor technique designed to compensate the bias due to the different dimensionality of individual entropy terms. The resulting estimators of prediction entropy, storage entropy, transfer entropy, and partial transfer entropy are tested on simulations of coupled linear stochastic and nonlinear deterministic dynamic processes, demonstrating the superiority of the proposed approach over the traditional estimators based on uniform embedding. The framework is then applied to multivariate physiologic time series, resulting in physiologically well-interpretable information decompositions of cardiovascular and cardiorespiratory interactions during head-up tilt and of joint brain-heart dynamics during sleep.
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Affiliation(s)
- Luca Faes
- BIOtech, Department of Industrial Engineering, University of Trento and IRCS Program, PAT-FBK, 38122 Trento, Italy
| | - Dimitris Kugiumtzis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Giandomenico Nollo
- BIOtech, Department of Industrial Engineering, University of Trento and IRCS Program, PAT-FBK, 38122 Trento, Italy
| | - Fabrice Jurysta
- Sleep Laboratory, Department of Psychiatry, Université Libre de Bruxelles, Erasme Academic Hospital, 1050 Brussels, Belgium
| | - Daniele Marinazzo
- Department of Data Analysis, University of Ghent, 9000 Ghent, Belgium
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Tsai HJ, Kuo TBJ, Lee GS, Yang CCH. Efficacy of paced breathing for insomnia: enhances vagal activity and improves sleep quality. Psychophysiology 2014; 52:388-96. [PMID: 25234581 DOI: 10.1111/psyp.12333] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 08/12/2014] [Indexed: 11/29/2022]
Abstract
Fourteen self-reported insomniacs (SRI) and 14 good sleepers (GS) had their cardiac neuronal activity assessed by heart rate variability (HRV) under controlled respiration at a slow frequency rate of 0.1 Hz, and a forced rate of 0.2 Hz during daytime rest. Nighttime sleep was measured by polysomnography. The SRI showed depressed high frequency power of HRV compared to the GS. An increased total power of HRV was observed among the SRI during slow, paced breathing compared with spontaneous breathing and 0.2 Hz. Sleep onset latency, number of awakenings, and awakening time during sleep were decreased and sleep efficiency was increased if SRI practiced slow, paced breathing exercises for 20 min before going to sleep. Our results indicate that there is autonomic dysfunction among insomniacs, especially in relation to vagal activity; however, this decreased vagal activity can be facilitated by practicing slow, paced breathing, thereby improving sleep quality.
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Affiliation(s)
- H J Tsai
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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McDuff D, Gontarek S, Picard RW. Improvements in remote cardiopulmonary measurement using a five band digital camera. IEEE Trans Biomed Eng 2014; 61:2593-601. [PMID: 24835124 DOI: 10.1109/tbme.2014.2323695] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Remote measurement of the blood volume pulse via photoplethysmography (PPG) using digital cameras and ambient light has great potential for healthcare and affective computing. However, traditional RGB cameras have limited frequency resolution. We present results of PPG measurements from a novel five band camera and show that alternate frequency bands, in particular an orange band, allowed physiological measurements much more highly correlated with an FDA approved contact PPG sensor. In a study with participants (n = 10) at rest and under stress, correlations of over 0.92 (p 0.01) were obtained for heart rate, breathing rate, and heart rate variability measurements. In addition, the remotely measured heart rate variability spectrograms closely matched those from the contact approach. The best results were obtained using a combination of cyan, green, and orange (CGO) bands; incorporating red and blue channel observations did not improve performance. In short, RGB is not optimal for this problem: CGO is better. Incorporating alternative color channel sensors should not increase the cost of such cameras dramatically.
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Kuo TBJ, Hong CH, Hsieh IT, Lee GS, Yang CCH. Effects of cold exposure on autonomic changes during the last rapid eye movement sleep transition and morning blood pressure surge in humans. Sleep Med 2014; 15:986-97. [PMID: 25011661 DOI: 10.1016/j.sleep.2014.03.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 02/24/2014] [Accepted: 03/19/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Various studies have linked the occurrence of cardiovascular events and low ambient temperatures as well as the morning blood pressure surge (MBPS). We hypothesized that low ambient temperatures produce a higher sympathetic change during the last rapid eye movement (REM) sleep transition and that this may play an important role in cold-related cardiovascular events. METHODS All experiments were carried out on 12 healthy male adults, aged 24.00±0.74 years, who participated in two experimental conditions randomly (>1 day apart): warm (23 °C) and cold (16°C). Blood pressure (BP) was measured every 30 min for 24 h by autonomic ambulatory BP monitoring. The electroencephalograms, electrocardiograms, ambient temperature, near-body temperature, and physical activity were recorded by miniature polysomnography for 24 h. RESULTS The cold conditions resulted in: (i) higher MBPS than under warm conditions; (ii) significant and greater sympathetic index changes during the sleep-wake transition than during cover-to-uncover and supine-to-sit position tests; (iii) the non-REM-REM transition-related sympathetic elevation during the cold conditions being significantly higher in late sleep period than in early sleep period; (iv) at 1h prior to morning awakening, the value of total power of heart rate variability changes being significantly negatively correlated with the changes of near-body temperature; and (v) significantly higher arousal index and shorter average interval of REM periods than in warm conditions. CONCLUSION Cold exposure elevates the amplitude of MBPS and is associated with late sleep stage transition sympathetic activation, which might have important implications for cold-related cardiovascular events.
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Affiliation(s)
- Terry B J Kuo
- Sleep Research Center, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Biophotonics, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Cian-Hui Hong
- Sleep Research Center, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - I-Te Hsieh
- Sleep Research Center, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Biophotonics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Guo-She Lee
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Cheryl C H Yang
- Sleep Research Center, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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The role of autonomic and baroreceptor reflex control in blood pressure dipping and nondipping in rats. J Hypertens 2014; 32:806-16. [DOI: 10.1097/hjh.0000000000000099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kuo TBJ, Li JY, Lai CT, Huang YC, Hsu YC, Yang CCH. The effect of bedding system selected by manual muscle testing on sleep-related cardiovascular functions. BIOMED RESEARCH INTERNATIONAL 2013; 2013:937986. [PMID: 24371836 PMCID: PMC3859264 DOI: 10.1155/2013/937986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/30/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Different types of mattresses affect sleep quality and waking muscle power. Whether manual muscle testing (MMT) predicts the cardiovascular effects of the bedding system was explored using ten healthy young men. METHODS For each participant, two bedding systems, one inducing the strongest limb muscle force (strong bedding system) and the other inducing the weakest limb force (weak bedding system), were identified using MMT. Each bedding system, in total five mattresses and eight pillows of different firmness, was used for two continuous weeks at the participant's home in a random and double-blind sequence. A sleep log, a questionnaire, and a polysomnography were used to differentiate the two bedding systems. RESULTS AND CONCLUSION Heart rate variability and arterial pressure variability analyses showed that the strong bedding system resulted in decreased cardiovascular sympathetic modulation, increased cardiac vagal activity, and increased baroreceptor reflex sensitivity during sleep as compared to the weak bedding system. Different bedding systems have distinct cardiovascular effects during sleep that can be predicted by MMT.
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Affiliation(s)
- Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Department of Education and Research, Taipei City Hospital, No. 145, Zhengzhou Rd., Datong Dist., Taipei 103, Taiwan
| | - Jia-Yi Li
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Department of Education and Research, Taipei City Hospital, No. 145, Zhengzhou Rd., Datong Dist., Taipei 103, Taiwan
| | - Chun-Ting Lai
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
| | - Yu-Chun Huang
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
| | - Ya-Chuan Hsu
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
- Sleep Research Center, National Yang-Ming University, No. 155, Section 2, Li-Nong Street, Taipei 11221, Taiwan
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Thomas RJ, Mietus JE, Peng CK, Guo D, Gozal D, Montgomery-Downs H, Gottlieb DJ, Wang CY, Goldberger AL. Relationship between delta power and the electrocardiogram-derived cardiopulmonary spectrogram: possible implications for assessing the effectiveness of sleep. Sleep Med 2013; 15:125-31. [PMID: 24269134 DOI: 10.1016/j.sleep.2013.10.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 09/25/2013] [Accepted: 10/05/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The physiologic relationship between slow-wave activity (SWA) (0-4 Hz) on the electroencephalogram (EEG) and high-frequency (0.1-0.4 Hz) cardiopulmonary coupling (CPC) derived from electrocardiogram (ECG) sleep spectrograms is not known. Because high-frequency CPC appears to be a biomarker of stable sleep, we tested the hypothesis that that slow-wave EEG power would show a relatively fixed-time relationship to periods of high-frequency CPC. Furthermore, we speculated that this correlation would be independent of conventional nonrapid eye movement (NREM) sleep stages. METHODS We analyzed selected datasets from an archived polysomnography (PSG) database, the Sleep Heart Health Study I (SHHS-I). We employed the cross-correlation technique to measure the degree of which 2 signals are correlated as a function of a time lag between them. Correlation analyses between high-frequency CPC and delta power (computed both as absolute and normalized values) from 3150 subjects with an apnea-hypopnea index (AHI) of ≤5 events per hour of sleep were performed. RESULTS The overall correlation (r) between delta power and high-frequency coupling (HFC) power was 0.40±0.18 (P=.001). Normalized delta power provided improved correlation relative to absolute delta power. Correlations were somewhat reduced in the second half relative to the first half of the night (r=0.45±0.20 vs r=0.34±0.23). Correlations were only affected by age in the eighth decade. There were no sex differences and only small racial or ethnic differences were noted. CONCLUSIONS These results support a tight temporal relationship between slow wave power, both within and outside conventional slow wave sleep periods, and high frequency cardiopulmonary coupling, an ECG-derived biomarker of "stable" sleep. These findings raise mechanistic questions regarding the cross-system integration of neural and cardiopulmonary control during sleep.
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Affiliation(s)
- Robert Joseph Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States.
| | - Joseph E Mietus
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States
| | - Chung-Kang Peng
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States
| | - Dan Guo
- Sleep Disorders Center, Meitan General Hospital, Beijing, China
| | - David Gozal
- Department of Pediatrics, University of Chicago, 5721 S. Maryland Ave, MC 8000, Suite K-160, Chicago, IL 60637, United States
| | - Hawley Montgomery-Downs
- Department of Psychology, West Virginia University, 53 Campus Dr., Morgantown, WV 26506, United States
| | - Daniel J Gottlieb
- Veterans Affairs Health Care System, 1400 VFW Pkwy, West Roxbury, MA 02132, United States
| | - Cheng-Yen Wang
- Research Center for Adaptive Data Analysis, National Central University, Chungli, Taiwan
| | - Ary L Goldberger
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States; Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA 02215, United States
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Shiau YH, Sie JH, Li SP. Detecting sleep apnea by volatility clustering of heart rate variability. Int J Cardiol 2013; 168:1638-40. [DOI: 10.1016/j.ijcard.2013.01.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
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On-call duty effects on sleep-state physiological stability in male medical interns. PLoS One 2013; 8:e65072. [PMID: 23750232 PMCID: PMC3672167 DOI: 10.1371/journal.pone.0065072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 04/21/2013] [Indexed: 01/08/2023] Open
Abstract
Background On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC) analysis to test our hypothesis. Methods We used electrocardiogram (ECG)-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period. Results The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM) sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Conclusion Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.
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Liu KD, Shan DE, Kuo TBJ, Yang CCH. The effects of bilateral stimulation of the subthalamic nucleus on heart rate variability in patients with Parkinson’s disease. J Neurol 2013; 260:1714-23. [DOI: 10.1007/s00415-013-6849-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 11/25/2022]
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Kuo TBJ, Lai CT, Chen CY, Lee GS, Yang CCH. Unstable sleep and higher sympathetic activity during late-sleep periods of rats: implication for late-sleep-related higher cardiovascular events. J Sleep Res 2012; 22:108-18. [PMID: 22957846 DOI: 10.1111/j.1365-2869.2012.01046.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We proposed that the higher incidence of sleep fragmentation, sympathovagal imbalance and baroreceptor reflex impairment during quiet sleep may play a critical role in late-sleep-related cardiovascular events. Polysomnographic recording was performed through wireless transmission using freely moving Wistar-Kyoto rats over 24 h. The low-frequency power of arterial pressure variability was quantified to provide an index of vascular sympathetic activity. Spontaneous baroreflex sensitivity was assessed by slope of arterial pressure-RR linear regression. As compared with early-light period (Zeitgeber time 0-6 h), rats during the late-light period (Zeitgeber time 6-12 h) showed lower accumulated quiet sleep time and higher paradoxical sleep time; furthermore, during quiet sleep, the rats showed a lower δ% of electroencephalogram, more incidents of interruptions, higher σ% and higher β% of electroencephalogram, raised low-frequency power of arterial pressure variability value and lower baroreflex sensitivity parameters. During the light period, low-frequency power of arterial pressure variability during quiet sleep had a negative correlation with accumulated quiet sleep time and δ% of electroencephalogram, while it also had a positive correlation with σ% and β% of electroencephalogram and interruption events. However, late-sleep-related raised sympathetic activity and sleep fragmentation diminished when an α1-adrenoceptor antagonist was given to the rats. Our results suggest that the higher incidence of sleep fragmentation and sympathovagal imbalance during quiet sleep may play a critical role in late-sleep-related cardiovascular events. Such sleep fragmentation is coincident with an impairment of baroreflex sensitivity, and is mediated via α1-adernoceptors.
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Affiliation(s)
- Terry B J Kuo
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
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Chang YC, Huang SL. The influence of attention levels on psychophysiological responses. Int J Psychophysiol 2012; 86:39-47. [PMID: 22960315 DOI: 10.1016/j.ijpsycho.2012.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 08/30/2012] [Accepted: 09/01/2012] [Indexed: 11/16/2022]
Abstract
This study aimed to examine which brain oscillatory activities and peripheral physiological measures were influenced by attention levels. A new experimental procedure was designed. Participants were asked to count the number of target events while viewing eight moving white circles. An event occurred when two of the circles changed from white to red or blue. In the low-attention task, similar to a feature search, the target events were defined by color only. In the high-attention task, similar to a conjunction search, the target events were defined by both color and size. In the control task, participants were asked to passively watch the series of events while remembering a number. Based on Feature Integration Theory, our high-attention task would demand more attentional investment than the low-attention task. Given the identical visual stimuli and requirement of keeping a number in working memory for all three tasks, the changes in brain oscillatory activities can be attributed to attention level rather than to perceptual content or memory processes. Peripheral measures such as heart rate, heart rate variability (HRV), respiration rate, eye blinks, and skin conductance level were also evaluated. In comparing the high-attention task with the low-attention task, theta synchronization at the Fz, Cz, and Pz electrodes as a group, alpha2 desynchronization at the Fz, Cz, Pz, and Oz electrodes as a group, and a decrease in the low-frequency component and ratio measure of HRV were evident. These measures are considered to be promising indices for discriminating between attention levels.
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Affiliation(s)
- Yu-Chieh Chang
- Department of Psychology, National Chengchi University, Taiwan
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Kuo TB, Chen C, Hsu YC, Yang CC. Performance of the frequency domain indices with respect to sleep staging. Clin Neurophysiol 2012; 123:1338-45. [PMID: 22153785 DOI: 10.1016/j.clinph.2011.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/06/2011] [Accepted: 11/04/2011] [Indexed: 10/14/2022]
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