Hall Martica, Vasko Raymond, Buysse Daniel, Ombao Hernando, Chen Qingxia, Cashmere J David, Kupfer David, Thayer Julian F
University of Pittsburgh Department of Psychiatry, Pittsburgh, PA, USA.
Psychosom Med. 2004 Jan-Feb;66(1):56-62. doi: 10.1097/01.psy.0000106884.58744.09.
Although stress can elicit profound and lasting effects on sleep, the pathways whereby stress affects sleep are not well understood. In this study, we used autoregressive spectral analysis of the electrocardiogram (EKG) interbeat interval sequence to characterize stress-related changes in heart rate variability during sleep in 59 healthy men and women.
Participants (N = 59) were randomly assigned to a control or stress condition, in which a standard speech task paradigm was used to elicit acute stress in the immediate presleep period. EKG was collected throughout the night. The high frequency component (0.15-0.4 Hz Eq) was used to index parasympathetic modulation, and the ratio of low to high frequency power (0.04-0.15 Hz Eq/0.15-0.4 Hz Eq) of heart rate variability was used to index sympathovagal balance.
Acute psychophysiological stress was associated with decreased levels of parasympathetic modulation during nonrapid eye movement (NREM) and rapid eye movement sleep and increased levels of sympathovagal balance during NREM sleep. Parasympathetic modulation increased across successive NREM cycles in the control group; these increases were blunted in the stress group and remained essentially unchanged across successive NREM periods. Higher levels of sympathovagal balance during NREM sleep were associated with poorer sleep maintenance and lower delta activity.
Changes in heart rate variability associated with acute stress may represent one pathway to disturbed sleep. Stress-related changes in heart rate variability during sleep may also be important in association with chronic stressors, which are associated with significant morbidity and increased risk for mortality.
尽管压力可对睡眠产生深远且持久的影响,但压力影响睡眠的途径尚不清楚。在本研究中,我们使用心电图(EKG)心跳间期序列的自回归谱分析,来表征59名健康男性和女性在睡眠期间与压力相关的心率变异性变化。
参与者(N = 59)被随机分配至对照组或压力组,其中在睡前即刻使用标准言语任务范式引发急性压力。整夜收集心电图。高频成分(0.15 - 0.4 Hz等效值)用于指示副交感神经调制,心率变异性的低频与高频功率之比(0.04 - 0.15 Hz等效值/0.15 - 0.4 Hz等效值)用于指示交感迷走神经平衡。
急性心理生理压力与非快速眼动(NREM)睡眠和快速眼动睡眠期间副交感神经调制水平降低以及NREM睡眠期间交感迷走神经平衡水平升高有关。对照组中,副交感神经调制在连续的NREM周期中增加;这些增加在压力组中减弱,并且在连续的NREM期间基本保持不变。NREM睡眠期间较高的交感迷走神经平衡水平与较差的睡眠维持和较低的δ波活动有关。
与急性压力相关的心率变异性变化可能是睡眠紊乱的一条途径。睡眠期间与压力相关的心率变异性变化在与慢性应激源相关时也可能很重要,慢性应激源与显著的发病率和死亡率增加风险相关。