title: Scaling exponent values as an ordinary function of the ratio of very low frequency to high frequency powers in heart rate variability over various sleep stages.
abstract: OBJECTIVE
  To assess the physiological meanings of the detrended fluctuation analysis (DFA) slope α and its relationship to spectral measures in heart rate variability, this study investigated changes of α and its corresponding spectral measures over various night-sleep stages.
  
  
  METHODS
  The overall DFA α and natural-logarithm-transformed power values of the spectral parameters ln[high-frequency (HF)], ln[low-frequency (LF)], and ln[very-low-frequency (VLF)], and their relationship from one 5-min proper electrocardiography segment in each of pre-sleep-wakefulness (AWK), non-rapid eye movement stage 2 (N2), slow-wave (N3), the first and the latest rapid-eye movement sleep (REM1, and REM2), were computed in 93 otherwise healthy males (44.1 ± 7.7 years.) with wide-ranged apnea-hypopnea, periodic-limb movement and arousal indices (19.0 ± 20.9, 4.7 ± 9.9, and 10.7 ± 18.2 h, respectively).
  
  
  RESULTS
  While ln(HF) dipped from AWK, N2, and N3 to REM1 then rebounded to the origin level at REM2, ln(VLF) dipped from AWK to N2, N3 trough, and then surged to levels surpassing AWKs and N2s at REM1 and REM2. ln(LF/HF), ln(VLF/HF), and α dipped from AWK and N2 to N3 trough, surged to levels surpassing AWKs, and N2s at REM1 then became attenuated at REM2. By general linear modeling, the relationship between α and the corresponding spectral values can be seen over various stages as α = b 0 + 0.147 × ln(VLF/HF) (R (2) = 0.766), regardless of age and sleep-sympathoexcitatory episodes.
  
  
  CONCLUSIONS
  The REM sleep attenuations appeared in ln(HF) and its derivatives, such as ln(LF/HF), ln(VLF/HF), and the overall DFA slope α values. The quantitative function of ln(VLF/HF) describes the α values constantly for overnight sleep stages, and it is not affected by age, LF, PLM, and AHI. Our findings therefore suggest that in sleep studies with spectral HRV measures, ln(VLF/HF) as a surrogate of the overall DFA slope α should be calculated at the same time.
authors.affiliation: Department of Medical Image and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ren-Jing
authors.initials: RJ
authors.lastname: Huang
authors.affiliation: Department of Applied Information Sciences, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ching-Hsiang
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.|Department of Occupational Therapy, Asia University, Taichung, Taiwan.
authors.forename: Shin-Da
authors.initials: SD
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
authors.forename: Ling-Hui
authors.initials: LH
authors.lastname: Tseng
authors.affiliation: Department of Medical Image and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yu-Pin
authors.initials: YP
authors.lastname: Chen
authors.affiliation: Sleep Medicine Center, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
authors.forename: Shen-Wen
authors.initials: SW
authors.lastname: Chang
authors.affiliation: Sleep Medicine Center, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
authors.forename: Ai-Hui
authors.initials: AH
authors.lastname: Chung
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan. huating@csmu.edu.tw.|Sleep Medicine Center, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan. huating@csmu.edu.tw.|Institute of Medicine, Chung Shan Medical University, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan. huating@csmu.edu.tw.
authors.forename: Hua
authors.initials: H
authors.lastname: Ting
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001833:Body Temperature Regulation / Q000502:physiology; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012815:Signal Processing, Computer-Assisted; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology*; D013223:Statistics as Topic; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology*
keywords: Autonomic nervous system; Periodic limb movement; Sleep apnea; Thermoregulation; Vagus nerve