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Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea

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机构: [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China [2]Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA [3]State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People’s Republic of China
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关键词: heart rate variability insomnia sleepiness sleep quality periodic limb movements

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Background: Normal sleep is associated with typical physiological changes in both the central and autonomic nervous systems. In particular, nocturnal blood pressure dipping has emerged as a strong marker of normal sleep physiology, whereas the absence of dipping or reverse dipping has been associated with cardiovascular risk. However, nocturnal blood pressure is not measured commonly in clinical practice. Heart rate (HR) dipping in sleep may be a similar important marker and is measured routinely in at-home and in-laboratory sleep testing.& para;& para;Methods: We performed a retrospective cross-sectional analysis of diagnostic polysomnography in a clinically heterogeneous cohort of n=1047 adults without sleep apnea.& para;& para;Results: We found that almost half of the cohort showed an increased HR in stable nonrapid eye movement sleep (NREM) compared to wake, while only 13.5% showed a reduced NREM HR of at least 10% relative to wake. The strongest correlates of HR dipping were younger age and male sex, whereas the periodic limb movement index (PLMI), sleep quality, and Epworth Sleepiness Scale (ESS) scores were not correlated with HR dipping. PLMI was however significantly correlated with metrics of impaired HR variability (HRV): increased low-frequency power and reduced high-frequency power. HRV metrics were unrelated to sleep quality or the ESS value. Following the work of Vgontzas et al, we also analyzed the sub-cohort with insomnia symptoms and short objective sleep duration. Interestingly, the sleep wake stage-specific HR values depended upon insomnia symptoms more than sleep duration.& para;& para;Conclusion: While our work demonstrates heterogeneity in cardiac metrics (HR and HRV), the population analysis suggests that pathological signatures of HR (nondipping and elevation) are common even in this cohort selected for the absence of sleep apnea. Future prospective work in clinical populations will further inform risk stratification and set the stage for testing interventions.

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出版当年[2017]版:
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
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出版当年[2016]版:
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q2 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版]

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第一作者机构: [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
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通讯机构: [*1]Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Wang 7, 55 Fruit Street, Boston, MA 02114, USA
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