Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: preliminary findings using an ECG-based spectrogram method.
OBJECTIVE
To assess the effects of a 12-week Tai Chi exercise program on sleep using the sleep spectrogram, a method based on a single channel electrocardiogram (ECG)-derived estimation of cardiopulmonary coupling, previously shown to identify stable and unstable sleep states.


METHODS
We retrospectively analyzed 24-h continuous ECG data obtained in a clinical trial of Tai Chi exercise in patients with heart failure. Eighteen patients with chronic stable heart failure, left ventricular ejection fraction <or= 40% (mean [+/-standard deviation] age, 59+/-14 years, mean baseline ejection fraction 24%+/-8%, mean) were randomly assigned to receive usual care (N=10), which included pharmacological therapy and dietary and exercise counseling, or 12 weeks of Tai Chi training (N=8) in addition to usual care. Using the ECG-based sleep spectrogram, we compared intervention and control groups by evaluating baseline and 12-week high (stable) and low (unstable) frequency coupling (HFC & LFC, respectively) as a percentage of estimated total sleep time (ETST).


RESULTS
At 12 weeks, those who participated in Tai Chi showed a significant increase in HFC (+0.05+/-0.10 vs. -0.06+/-0.09 % ETST, p=0.04) and significant reduction in LFC (-0.09+/-0.09 vs. +0.13+/-0.13 % ETST, p<0.01), compared to patients in the control group. Correlations were seen between improved sleep stability and better disease-specific quality of life.


CONCLUSIONS
Tai Chi exercise may enhance sleep stability in patients with chronic heart failure. This sleep effect may have a beneficial impact on blood pressure, arrhythmogenesis and quality of life.
Yeh
Gloria Y
GY
Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, MA 02215, USA. gyeh@hms.harvard.edu
Mietus
Joseph E
JE
Peng
Chung-Kang
CK
Phillips
Russell S
RS
Davis
Roger B
RB
Wayne
Peter M
PM
Goldberger
Ary L
AL
Thomas
Robert J
RJ
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D005583:Fourier Analysis; D006333:Heart Failure / Q000523:psychology / Q000534:rehabilitation*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life / Q000523:psychology; D012815:Signal Processing, Computer-Assisted; D012892:Sleep Deprivation / Q000523:psychology / Q000534:rehabilitation*; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000534:rehabilitation*; D026302:Tai Ji
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