title: Sleep state instabilities in major depressive disorder: Detection and quantification with electrocardiogram-based cardiopulmonary coupling analysis.
abstract: Sleep disruption is an important aspect of major depressive disorder but lacks an objective and inexpensive means of assessment. We evaluated the utility of electrocardiogram (ECG)-based cardiopulmonary coupling analysis to quantify physiologic sleep stability in patients with major depression. Relative to controls, unmedicated depressed patients had a reduction in high-frequency coupling, an index of stable sleep, an increase in low-frequency coupling, an index of unstable sleep, and an increase in very-low-frequency coupling, an index of wakefulness/REM sleep. The medicated depressed group showed a restoration of stable sleep to a level comparable with that of the control group. ECG-based cardiopulmonary coupling analysis may provide a simple, cost-efficient point-of-care method to quantify sleep quality/stability and to objectively evaluate the severity of insomnia in patients with major depression.
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Chen-Jee
authors.initials: CJ
authors.lastname: Hong
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Tsai
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Chung-Hsun
authors.initials: CH
authors.lastname: Kuo
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Chung-Kang
authors.initials: CK
authors.lastname: Peng
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Mietus
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Ary L
authors.initials: AL
authors.lastname: Goldberger
authors.affiliation: Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, TaiwanDivision of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Interdisciplinary Medicine and Biotechnology and Margret and H. A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA and Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MADivision of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Thomas
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000209:etiology