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

Zhaoyang Huang,1 Balaji Goparaju,2 He Chen,3 Matt T Bianchi2 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA; 3State Key Laborat...

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Autores principales:	Huang Z, Goparaju B, Chen H, Bianchi MT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	heart rate variability insomnia sleepiness sleep quality periodic limb movements Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/f0aca3acbdb34f8f9eb0d53acf3cfc1d
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spelling	oai:doaj.org-article:f0aca3acbdb34f8f9eb0d53acf3cfc1d2021-12-02T02:42:30ZHeart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea1179-1608https://doaj.org/article/f0aca3acbdb34f8f9eb0d53acf3cfc1d2018-04-01T00:00:00Zhttps://www.dovepress.com/heart-rate-phenotypes-and-clinical-correlates-in-a-large-cohort-of-adu-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Zhaoyang Huang,1 Balaji Goparaju,2 He Chen,3 Matt T Bianchi2 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA; 3State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People’s Republic of China 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. Methods: We performed a retrospective cross-sectional analysis of diagnostic polysomnography in a clinically heterogeneous cohort of n=1047 adults without sleep apnea. 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. 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. Keywords: heart rate variability, insomnia, sleepiness, sleep quality, periodic limb movementsHuang ZGoparaju BChen HBianchi MTDove Medical Pressarticleheart rate variabilityinsomniasleepinesssleep qualityperiodic limb movementsPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 111-125 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	heart rate variability insomnia sleepiness sleep quality periodic limb movements Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	heart rate variability insomnia sleepiness sleep quality periodic limb movements Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Huang Z Goparaju B Chen H Bianchi MT Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
description	Zhaoyang Huang,1 Balaji Goparaju,2 He Chen,3 Matt T Bianchi2 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA; 3State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People’s Republic of China 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. Methods: We performed a retrospective cross-sectional analysis of diagnostic polysomnography in a clinically heterogeneous cohort of n=1047 adults without sleep apnea. 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. 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. Keywords: heart rate variability, insomnia, sleepiness, sleep quality, periodic limb movements
format	article
author	Huang Z Goparaju B Chen H Bianchi MT
author_facet	Huang Z Goparaju B Chen H Bianchi MT
author_sort	Huang Z
title	Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
title_short	Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
title_full	Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
title_fullStr	Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
title_full_unstemmed	Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
title_sort	heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/f0aca3acbdb34f8f9eb0d53acf3cfc1d
work_keys_str_mv	AT huangz heartratephenotypesandclinicalcorrelatesinalargecohortofadultswithoutsleepapnea AT goparajub heartratephenotypesandclinicalcorrelatesinalargecohortofadultswithoutsleepapnea AT chenh heartratephenotypesandclinicalcorrelatesinalargecohortofadultswithoutsleepapnea AT bianchimt heartratephenotypesandclinicalcorrelatesinalargecohortofadultswithoutsleepapnea
_version_	1718402258297683968

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

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