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[Sleep structure in relation to respiration and heart rate in children in puberty]

Authors:
A Unbehaun
A Unbehaun
A Unbehaun
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Andreas Patzak at Charité Universitätsmedizin Berlin
Andreas Patzak
Ralf Mrowka at Universitätsklinikum Jena
Ralf Mrowka
U Stangenberg
U Stangenberg
U Stangenberg
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Abstract

The different expression of respiratory sinus arrhythmia in REM- versus nonREM-sleep indicates a dependence of cardiorespiratory interaction on patterns of sleep. Investigations of the intensity of respiratory entrainment on heart rhythmicity during various stages of sleep will provide an insight into the coupling of cardiorespiratory interaction and sleep patterns. 42 healthy children (12 to 15 years old) were polygraphically investigated over 24 h. An ECG, EOG, and actogram were performed, respiratory movements were observed, and the skin temperature was taken. The power spectra of the instantaneous heart rate and the respirograms were calculated. The analysis of coherence was carried out to determine how pronounced the cardiorespiratory interaction is. REM-sleep, nonREM-phases, and wakefulness were compared. The spectral parameters of instantaneous heart rate show differences between both stages of sleep and the waking state. Due to a dependence of spectral power on breathing patterns, drawing quantitative conclusions is not possible. The analysis of coherence provides more information about sleep patterns within the cardiorespiratory interaction. It is very pronounced during non-REM-sleep (0.80 +/- 0.07; mean +/- standard deviation). Heart rhythmicity proceeds independent of breathing during REM-sleep (0.52 +/- 0.11). The coupling is weaker than during wakefulness (0.64 +/- 0.09).

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Die nichtlineare Dynamik der Herzfrequenz und die Kardiorespiratorische Kontrolle im Schlafen und Wachen
Article
  • May 1997
Die mittels linearer Verfahren (Kohärenzspektren) gemessene Kopplung zwischen Atmung und Herzfrequenzvariabilität ist im NREM-Schlaf hoch. Sowohl im REM-Schlaf als auch im Wachzustand liegt sie deutlich niedriger. Offen bleibt dabei, inwieweit nichtlineare Eigenschaften in der Steuerung von Atmung und instantaner Herzfrequenz (IHR) für diese Befunde verantwortlich sind. Daten von 42 Kindern im Alter von 12 bis 15 Jahren aus dem Wachzustand, REM- und NREM-Schlaf wurden hinsichtlich dieser Fragestellung untersucht. Gemessen wurden EKG, thorakales und abdominales Respirogramm, EOG und Aktogramm. Die Prädiktabilität der IHR wurde mittels größtem Lyapunov-Exponent (LLE) bestimmt. Die Komplexität der IHR und mit ihr die Zahl unabhängiger Steuermechanismen wurde aus der Korrelationsdimension (D2) abgeleitet. Der LLE zeigt im Wachzustand signifikant höhere Werte (0,28±0,10 bits/s) als im NREM-Schlaf (0,23±0,09 bits/s). Mit Beginn des REM-Schlafes steigt der LLE (0,26±0,07 bits/s) nicht signifikant an. D2 ist am kleinsten innerhalb des REM- Schlafes (3,30±0,41), höher innerhalb der NREM-Phasen (3,80±0,39) und am größten im Wachzustand (4,04±0,35) Die Ergebnisse sprechen für ein niederdimensionales deterministisch-chaotisches Verhalten der IHR. Der Anstieg von D2 bei gleichzeitiger Abnahme der linearen Intensität der kardiorespiratorischen Kopplung infolge des Erwachens spricht für eine Verdrängung respiratorischer Einflußnahme auf die Herzfrequenzsteuerung aufgrund von Umschaltungen innerhalb des neuronalen Netzwerkes. Die innerhalb der REM-Phasen erreichte hohe Autonomie der IHR von der Atmung dagegen scheint eine spezifische Eigenschaft dieses Schlafabschnitts zu sein. Concluded from linear methods (coherence analysis), the linear intensity of cardiorespiratory interaction is high during NREM-sleep. It is diminished during wakefulness and REM-sleep. However, it is unclear how non-linear cardiorespiratory control mechanisms influence the results of linear methods. Therefore, 42 children at the age of 12 to 15 years were investigated during wakefulness, REM-, and NREM-sleep. An ECG, EOG, and actogram were performed and the respiratory movements of the chest and abdomen were recorded. The predictability of the time series of the instantaneous heart rate (IHR) was estimated calculating the largest Lyapunov exponent (LLE). The complexity of IHR and the number of independent control loops were concluded from the correlation dimension (D2). The LLE is significantly higher during wakefulness (0.28±0.10 bits/s) compared with NREM-sleep (0.23±0.09 bits/s). It does not increase significantly during REM-phases (0.26 ± 0.07 bits/s). D2 is low during REM-sleep (3.30±0.41), increased during NREM-phases (3.80±0.39), and high during wakefulness (4.04±0.35). The results point out to a low-dimensional deterministic-chaotic pattern of IHR. Concluded from the increase in D2 and the decrease in coherence caused by awakening, respiratory entrainment on heart rate control may be displaced by other activated control loops. Contrary, IHR and respiration work more autonomously during REM-sleep. Obviously, there is a characteristic operating point during that state of sleep.
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