Vagal cardiac control throughout the day: the relative importance of effort-reward imbalance and within-day measurements of mood, demand and satisfaction.

The effects of variables derived from a work stress theory (the effort-reward imbalance theory) on the power in the high frequency (HF_HRV) band of heart rate (0.14-0.40 Hz) throughout a work day, were determined using multilevel analysis. Explanatory variables were analysed at two levels: at the lowest level (within-day level), the effects of positive mood, negative mood, demand, satisfaction, demand-satisfaction ratio, and time of day were assessed. At the highest level (the subject level), the effects of sleep quality, effort, reward, effort-reward imbalance, need for control, type of work (profession), negative affectivity, gender and smoking on HF_HRV were assessed. Need for control has a negative effect on HF_HRV after controlling for time of day effects, i.e. subjects with a high need for control have a lower vagal control of the heart. In the long run, these subjects may be considered to be at increased health risk, because they have less of the health protective effects of vagal tone. The interaction between effort-reward imbalance and time of day has a positive effect on HF_HRV, i.e. the cardiac vagal control of subjects with a high effort-reward imbalance increases as the day progresses. It is discussed that this probably reflects reduced effort allocation, ensuing from disengagement from the work demands.