title: Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: preliminary findings using an ECG-based spectrogram method.
abstract: 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.
authors: Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, MA 02215, USA. gyeh@hms.harvard.edu
authors: Gloria Y
authors: GY
authors: Yeh
authors: Joseph E
authors: JE
authors: Mietus
authors: Chung-Kang
authors: CK
authors: Peng
authors: Russell S
authors: RS
authors: Phillips
authors: Roger B
authors: RB
authors: Davis
authors: Peter M
authors: PM
authors: Wayne
authors: Ary L
authors: AL
authors: Goldberger
authors: Robert J
authors: RJ
authors: Thomas
mesh_terms: 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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