Developmental aspects of the interaction between the controls of heart rate and respiratory rhythm--linear and nonlinear components of diverse activity states in childhood.

Heart beat and respiration are rhythmical phenomena with separate intrinsic frequencies which necessarily have to be effectively tuned by a network of interactive processes. Their linear and nonlinear components may ripen in different ways during childhood thus leading to unstable transitions or risk of dangerous events. This study investigates the development from newborns to children mainly between sleep and wakefulness. 42 healthy untrained children underwent a 24 hours monitoring of ECG, respiration, actogram, and EOG. Linear parameters such as respiratory rate, heart period duration (HPD), total and high frequency spectral power (TP, HFP), low/high frequency power quotient (LF/HF) and coherence were calculated in wake state, REM- and non-REM sleep. The largest Lyapunov exponent (LLE) was evaluated as nonlinear parameter and proved by the surrogate data method. The childrendata were compared to newborndata at days 1 and 180. In wake children, all values except TP differ from that in non-REM and except LLE from that in REM. All linear parameters differ between REM and non-REM. Similar differences exist for quiet to active sleep in newborns at day 1. At day 180 only LF/HF and coherence differ. Development from day 1 to 180 exists in quiet sleep for LF/HF and coherence, in active sleep additionally for LLE and from day 180 to children except for LF/HF and coherence. The results show clear differences in the linear parameters of the activity states. Wakefulness, REM- and non-REM sleep, therefore, follow varied rhythmical controls. The behaviour of LF/HF points to changes in the intensity of vagal participation and that of the coherence accentuates the differing tightness of the coupling. The clearly existing nonlinear components have a separate value only in wakefulness hinting at larger complexity at that state. The development within the first 180 days indicates an increase of vagal participation and tightness of coupling in quiet sleep, in active sleep also an increase in complexity. From that day no further development in vagal and coupling effects has been detected among children. The complexity remains unchanged, only the power parameters expressing heart rate variability increase. (Fig. 3, Tab. 3, Ref. 13.)