title: Heart rate variability during sleep in children with autism spectrum disorder.
abstract: Autonomic dysfunction has been reported in autism spectrum disorders (ASD). Less is known about autonomic function during sleep in ASD. The objective of this study is to provide insight into the autonomic cardiovascular control during different sleep stages in ASD. We hypothesized that patients with ASD have lower vagal and higher sympathetic modulation with elevated heart rate, as compared to typical developing children (TD).
  
  
  
  We studied 21 children with ASD and 23 TD children during overnight polysomnography. Heart rate and spectral parameters were calculated for each vigilance stage during sleep. Data from the first four sleep cycles were used to avoid possible effects of different individual sleep lengths and sleep cycle structures. Linear regression models were applied to study the effects of age and diagnosis (ASD and TD).
  
  
  
  In both groups, HR decreased during non-REM sleep and increased during REM sleep. However, HR was significantly higher in stages N2, N3 and REM sleep in the ASD group. Children with ASD showed less high frequency (HF) modulation during N3 and REM sleep. LF/HF ratio was higher during REM. Heart rate decreases with age at the same level in ASD and in TD. We found an age effect in LF in REM different in ASD and TD.
  
  
  
  Our findings suggest possible deficits in vagal influence to the heart during sleep, especially during REM sleep. Children with ASD may have higher sympathetic dominance during sleep but rather due to decreased vagal influence.
authors.affiliation: Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA.|Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA.
authors.forename: René
authors.initials: R
authors.lastname: Harder
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.|Vanderbilt Sleep Division, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Malow
authors.affiliation: Vanderbilt Sleep Division, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: R Lucas
authors.initials: RL
authors.lastname: Goodpaster
authors.affiliation: Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA.
authors.forename: Fahad
authors.initials: F
authors.lastname: Iqbal
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Halbower
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Goldman
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Diane B
authors.initials: DB
authors.lastname: Fawkes
authors.affiliation: Department of Statistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Lily
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Statistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA.
authors.forename: Franz
authors.initials: F
authors.lastname: Baudenbacher
authors.affiliation: Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN, USA. andre.diedrich@vanderbilt.edu.|Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, 1161 21st Avenue South, Suite AA3228 MCN, Nashville, TN, 37232-2195, USA. andre.diedrich@vanderbilt.edu.
authors.forename: André
authors.identifier: 0000-0001-5643-0294
authors.initials: A
authors.lastname: Diedrich
mesh_terms: D000375:Aging; D000067877:Autism Spectrum Disorder / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D017286:Polysomnography; D012890:Sleep; D012894:Sleep Stages; D012895:Sleep, REM
keywords: Autism; Autonomic system; Heart rate variability; Sleep