Heart rate variability in normal and pathological sleep

Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a no...

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Veröffentlicht in:Frontiers in physiology Jg. 4; S. 294
Hauptverfasser: Tobaldini, Eleonora, Nobili, Lino, Strada, Silvia, Casali, Karina R., Braghiroli, Alberto, Montano, Nicola
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland Frontiers Media S.A 16.10.2013
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ISSN:1664-042X, 1664-042X
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Abstract Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non-linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non-linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non-linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.
AbstractList Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.
Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non-linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non-linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non-linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non-linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non-linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non-linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.
Author Strada, Silvia
Montano, Nicola
Nobili, Lino
Tobaldini, Eleonora
Casali, Karina R.
Braghiroli, Alberto
AuthorAffiliation 1 Division of Medicine and Pathophysiology, Department of Biomedical and Clinical Sciences “L. Sacco,” L. Sacco Hospital, University of Milan Milan, Italy
3 Department of Science and Technology, Science and Technology Institute, Federal University of São Paulo, São José dos Campos Sao Paulo, Brazil
5 Sleep Medicine Unit, Fondazione S. Maugeri Veruno, Italy
4 Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology Porto Alegre, Brazil
6 International Clinical Research Center, St. Anne University Hospital Brno, Czech Republic
2 Department of Neuroscience, Centre for Epilepsy Surgery “C. Munari,” Centre of Sleep Medicine, Niguarda Ca' Granda Hospital Milan, Italy
AuthorAffiliation_xml – name: 3 Department of Science and Technology, Science and Technology Institute, Federal University of São Paulo, São José dos Campos Sao Paulo, Brazil
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– name: 5 Sleep Medicine Unit, Fondazione S. Maugeri Veruno, Italy
– name: 6 International Clinical Research Center, St. Anne University Hospital Brno, Czech Republic
– name: 1 Division of Medicine and Pathophysiology, Department of Biomedical and Clinical Sciences “L. Sacco,” L. Sacco Hospital, University of Milan Milan, Italy
– name: 4 Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology Porto Alegre, Brazil
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  surname: Tobaldini
  fullname: Tobaldini, Eleonora
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  surname: Nobili
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  givenname: Silvia
  surname: Strada
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  givenname: Karina R.
  surname: Casali
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  givenname: Alberto
  surname: Braghiroli
  fullname: Braghiroli, Alberto
– sequence: 6
  givenname: Nicola
  surname: Montano
  fullname: Montano, Nicola
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Copyright Copyright © 2013 Tobaldini, Nobili, Strada, Casali, Braghiroli and Montano. 2013
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Keywords obstructive sleep apnea
sleep
autonomic nervous system
SUDEP
heart rate variability
non-linear analysis
insomnia
Language English
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Edited by: Karin Trimmel, Medical University of Vienna, Austria
Reviewed by: Ferdinando Iellamo, University of Rome Tor Vergata, Italy; Fumiharu Togo, The University of Tokyo, Japan
This article was submitted to Cardiac Electrophysiology, a section of the journal Frontiers in Physiology.
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SubjectTerms Autonomic Nervous System
Heart rate variability
insomnia
obstructive sleep apnea
Physiology
Sleep
Sleep Deprivation
Title Heart rate variability in normal and pathological sleep
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