Associations of Reduced Sympathetic Neural Activity and Elevated Baroreflex Sensitivity With Non–Rapid Eye Movement Sleep: Evidence From Electroencephalogram- and Electrocardiogram-Based Sleep Staging. Issue 5 (14th June 2022)

• Record Type: Journal Article
• Authors: Tsai, Hsin-Jung; Yang, Albert C.; Tsai, Shih-Jen; Ma, Yan; Kuo, Terry B.J.; Yang, Cheryl C.H.; Peng, Chung-Kang
• Is Part Of: Psychosomatic medicine. Volume 84:Issue 5(2022)
• Page Start: 621
• Page End: 631
• Publication Date: 2022-06-14
• Subjects: sleep scoring -- cardiopulmonary coupling -- slow-wave sleep -- heart rate variability -- blood pressure variability -- baroreflex sensitivity -- ANS = autonomic nervous system -- BLF = low-frequency power of BPV -- BPV = blood pressure variability -- BrrA = ascending baroreceptor reflex index -- BrrD = descending baroreceptor reflex index -- BrrHF = transfer function in low-frequency range -- BrrLF = transfer function in low-frequency range -- CAP = cyclic alternating pattern -- CPC = cardiopulmonary coupling -- DBP = diastolic blood pressure -- DistS = disturbed sleep -- ECG = electrocardiogram -- EEG = electroencephalogram -- EMG = electromyogram -- HF = high-frequency power of HRV -- HF% = HF normalized unit -- HRV = heart rate variability -- LF = low-frequency power of HRV -- LF% = LF in normalized unit -- N1 = NREM stage 1 -- N2 = NREM stage 2 -- N3 = NREM stage 3 -- nAW = nocturnal awakening -- NREM = non–rapid eye movement sleep -- PSG = polysomnography -- REM = rapid eye movement sleep -- RS = restful sleep -- SBP = systolic blood pressure -- W/R = wake/REM; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000001079
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: Autonomic neural controls in sleep regulation have been previously demonstrated; however, whether these alternations can be observed by different sleep staging approaches remains unclear. Two established methods for sleep staging—the standardized visual scoring and the cardiopulmonary coupling (CPC) analysis based on electrocardiogram—were used to explore the cardiovascular profiles of sleep. Methods: Overnight polysomnography was recorded together with continuous beat-to-beat blood pressure. Cortical activity, heart rate variability, blood pressure variability, and baroreflex sensitivity during sleep stages from 24 nights of sleep were obtained from 15 normotensive participants and analyzed. Results: Non–rapid eye movement sleep (NREM) from visual scoring and restful sleep (RS) of CPC both showed the highest delta power of electroencephalogram (EEG) and lowest beta activity of EEG in comparison with other sleep stages ( p < .001); likewise, the lowest total power of heart rate variability and suppressed vascular-sympathetic activity, reflected by low-frequency power of blood pressure variability, as well as a trend in elevated baroreflex sensitivity, were observed in the NREM or RS. This suppressed vascular-sympathetic activity during stable sleep further exhibited a significant correlation with increased slow-wave activity (NREM: r = −0.292 ± 0.34, p = .002; RS: r = −0.209 ± 0.30, p = .010). Conclusions: Autonomic nervous system is evidently associated with stable sleep, as indicated by the similar findings obtained from sleep stages categorized by standardized visual scoring or CPC analysis. Such association between cardiovascular neural activity and sleep EEGs can be observed regardless of the sleep staging approach followed.