title: The impact of cyclic alternating pattern on heart rate variability during sleep in healthy young adults.
abstract: OBJECTIVE
  Cyclic alternating pattern (CAP) consists of arousal-related phasic events while the complementary condition, non-CAP (NCAP), is characterized by a rhythmic background activity, reflecting a condition of stable arousal, during non-REM sleep. The arousal swings that accompany the appearance of CAP on the EEG are associated with transient variations of muscle tone and autonomic activities, including heart rate (HR). The aim of our study was to evaluate HR variability in relation to CAP during non-REM sleep in healthy adults.
  
  
  METHODS
  Ten healthy subjects (mean age = 28.1 years) underwent 8 h polysomnography. HR variations were measured by power spectrum analysis. The ECG signals were segmented in correspondence of the different sleep stages and different CAP conditions.
  
  
  RESULTS
  A significant difference between CAP and NCAP conditions was found in low frequency (LF) component (increased in CAP) and high frequency (HF) component (decreased in CAP). LF/HF ratio was increased in CAP.
  
  
  CONCLUSIONS
  Physiological fluctuations of the EEG arousal level influence cardiac autonomic activity in normal subjects. The studies on nocturnal variation in sympathetic and vagal tone should take in account the microstructural sleep changes, other than the conventional polysomnographic parameters.
authors.affiliation: Sleep Disorders Center, University of Milano and IRCCS H San Raffaele, Milan, Italy. ferinistrambi.luigi@hsr.it
authors.forename: L
authors.initials: L
authors.lastname: Ferini-Strambi
authors.forename: A
authors.initials: A
authors.lastname: Bianchi
authors.forename: M
authors.initials: M
authors.lastname: Zucconi
authors.forename: A
authors.initials: A
authors.lastname: Oldani
authors.forename: V
authors.initials: V
authors.lastname: Castronovo
authors.forename: S
authors.initials: S
authors.lastname: Smirne
mesh_terms: D000204:Activity Cycles; D000328:Adult; D001143:Arousal / Q000502:physiology; D004562:Electrocardiography; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D012016:Reference Values; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology