Wang Wenli, Tretriluxana Suradej, Redline Susan, Surovec Susan, Gottlieb Daniel J, Khoo Michael C K
Biomedical Engineering Department, University of Southern California, Los Angeles, CA 90089-0260, USA.
J Sleep Res. 2008 Sep;17(3):251-62. doi: 10.1111/j.1365-2869.2008.00652.x. Epub 2008 Jun 28.
The goal of this study was to test the hypothesis that spectral indices of heart rate variability, such as high-frequency power (HFP), low-to-high frequency power (LHR), and their respiration-adjusted counterparts (HFPra, LHRra) are correlated with severity of sleep-disordered breathing (SDB), as quantified by the respiratory disturbance index (RDI). A total of 436 subjects, non-smoking, normotensive, and free of cardiovascular disease and diabetes were selected from the Sleep Heart Health Study (SHHS). Of these, 288 records with sufficiently high quality electrocardiogram signals were selected for further analysis [males/females: 221/67; age: 46.1 to 74.9 years; body mass index (BMI): 21.5 to 46.4 kg m(-2); 0.3 < RDI < 85.0(-1)]. From each polysomnogram, the respiration channels (thoracic and abdominal) and R-R interval (RRI) derived from the electrocardiogram were subjected to spectral analysis and autoregressive moving average modeling in consecutive 5-min segments. After adjusting for age and BMI, mean RRI was found to be negatively correlated with RDI in men in all sleep-wake states (all P < 0.001). HFP and HFPra were negatively correlated with RDI in men only during wakefulness (all P < 0.01). In women, LHR and LHRra were not correlated with RDI during wakefulness, but were positively correlated during non-rapid eye movement Stage 1 and 2 sleep (all P < 0.01). These findings suggest that the indices of cardiac autonomic control are correlated with SDB severity, but gender and state affect the nature of these correlations. In both genders, however, vagal modulation of heart rate increases while sympathetic modulation decreases from wakefulness to sleep.
心率变异性的频谱指标，如高频功率（HFP）、低频与高频功率之比（LHR）及其经呼吸调整后的对应指标（HFPra、LHRra）与睡眠呼吸障碍（SDB）的严重程度相关，呼吸紊乱指数（RDI）可量化该严重程度。从睡眠心脏健康研究（SHHS）中选取了436名非吸烟、血压正常且无心血管疾病和糖尿病的受试者。其中，选取了288份具有足够高质量心电图信号的记录进行进一步分析[男性/女性：221/67；年龄：46.1至74.9岁；体重指数（BMI）：21.5至46.4 kg·m⁻²；0.3 < RDI < 85.0（次/小时）]。对每份多导睡眠图，将呼吸通道（胸部和腹部）以及从心电图得出的RR间期（RRI）在连续的5分钟时间段内进行频谱分析和自回归移动平均建模。在调整年龄和BMI后，发现所有睡眠 - 觉醒状态下男性的平均RRI与RDI呈负相关（所有P < 0.001）。仅在清醒状态下，男性的HFP和HFPra与RDI呈负相关（所有P < 0.01）。在女性中，清醒时LHR和LHRra与RDI不相关，但在非快速眼动睡眠第1和第2阶段呈正相关（所有P < 0.01）。这些发现表明，心脏自主控制指标与SDB严重程度相关，但性别和状态会影响这些相关性的性质。然而，在两种性别中，从清醒到睡眠，心率的迷走神经调节增加而交感神经调节减少。
