Association between heart rate variability, blood pressure and autonomic activity in cyclic alternating pattern during sleep.
OBJECTIVE
Cyclic alternating pattern (CAP) is frequently followed by changes in heart rate (HR) and blood pressure (BP), but the sequential associations between CAP and autonomic nerve activity have not been studied. The study aimed to reveal the precise changes in heart rate variability (HRV) during phase A of the CAP cycle.


METHODS
Polysomnography was recorded according to the CAP Atlas (Terzano, 2002), and BP and electrocardiogram were simultaneously recorded. The complex demodulation method was used for analysis of HRV and evaluation of autonomic nerve activity.


METHODS
Academic sleep laboratory.


METHODS
Ten healthy males.


RESULTS
The increase in HR (median [first quartile - third quartile]) for each subtype was as follows: A1, 0.64 (-0.30 to 1.69), A2, 1.44 (0.02 to 3.79), and A3, 6.24 (2.53 to 10.76) bpm (A1 vs. A2 P < 0.001, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). The increase in BP for each subtype was as follows: A1, 1.23 (-2.04 to 5.75), A2, 1.76 (-1.46 to 9.32), and A3, 12.51 (4.75 to 19.94) mm Hg (A1 vs. A2 P = 0.249, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). In all of phase A, the peak values for HR and BP appeared at 4.2 (3.5 to 5.4) and 8.4 (7.0 to 10.3) seconds, respectively, after the onset of phase A. The area under the curve for low-frequency and high-frequency amplitude significantly increased after the onset of CAP phase A (P < 0.001) and was higher in the order of subtype A3, A2, and A1 (P < 0.001).


CONCLUSIONS
All phase A subtypes were accompanied with increased heart rate variability, and the largest heart rate variability was seen in subtype A3, while a tendency for less heart rate variability was seen in subtype A1.
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Hideaki
H
Kondo
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan ; Sleep & Circadian Neurobiology Laboratory, Stanford Sleep Research Center, Stanford University School of Medicine, Palo Alto, CA.
Motohiro
M
Ozone
NoruPro Light Systems, Tokyo, Japan.
Noboru
N
Ohki
Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.
Yohei
Y
Sagawa
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Keiichirou
K
Yamamichi
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Mitsuki
M
Fukuju
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Takeshi
T
Yoshida
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Chikako
C
Nishi
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Akiko
A
Kawasaki
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Kaori
K
Mori
Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.
Takashi
T
Kanbayashi
Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
Motomori
M
Izumi
Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.
Yasuo
Y
Hishikawa
Sleep & Circadian Neurobiology Laboratory, Stanford Sleep Research Center, Stanford University School of Medicine, Palo Alto, CA.
Seiji
S
Nishino
Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.
Tetsuo
T
Shimizu
D001341:Autonomic Nervous System / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D004562:Electrocardiography; D004569:Electroencephalography; D064368:Healthy Volunteers; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology; D013997:Time Factors; D055815:Young Adult
Cyclic alternating pattern; autonomic nerve activation; blood pressure; complex demodulation method; heart rate variability