Key result
Cortical arousals during sleep were associated with significant increases in heart rate and heart rate variability during arousal onset across all arousal etiologies, with more intense variations observed in females and during REM sleep.
Why the study?
Few studies have examined the instantaneous association between cortical arousal and heart rate variability in an ethnically diverse population.
Does cortical arousal affect heart rate variability and heart rate in an ethnically diverse population?
Cross-Sectional (n=1,069)
Yes
Does cortical arousal affect heart rate variability and heart rate in an ethnically diverse population?
Cortical arousals during sleep are associated with instantaneous increases in heart rate and heart rate variability, with more intense variations observed in females and during REM sleep.
May warrant consideration of arousal-related HR surges in sleep studies; leaves open prospective validation for CV risk stratification.
Frequent cortical arousal is associated with cardiovascular dysfunction among people with sleep-disordered breathing. Changes in heart rate variability (HRV) can represent pathological conditions associated with autonomic nervous system dysfunction. Previous studies showed changes in cardiac activity due to cortical arousals. However, few studies have examined the instantaneous association between cortical arousal and HRV in an ethnically diverse population. In this study, we included 1,069 subjects' full night ECG signals from unattended polysomnography in the Multi-Ethnic Study of Atherosclerosis dataset. An automated deep learning tool was employed to annotate arousal events from ECG signals. The etiology (e.g., respiratory, or spontaneous) of each arousal event was classified through a temporal analysis. Time domain HRVs and mean heart rate were calculated on pre-, intra-, and post-arousal segments of a 25-s period for each arousal event. We observed that heart rate and HRVs increased during the arousal onsets in the intra-arousal segments, regardless of arousal etiology. Furthermore, HRVs response to cortical arousal occurrence differed according to gender and the sleep stages in which arousal occurred. The more intense HRVs variation due to arousal in females can contribute to a potentially stronger association between arousal burden and long-term mortality. The excessive abrupt sympathetic tone elevation in REM caused by arousal may provide insights on the association between sleep and sudden cardiac death.
No takes yet. Share an insight, caveat, or question.
Huo et al. (2023) conducted a cross-sectional in Sleep-disordered breathing and cortical arousals (n=1,069). Cortical arousal vs. Pre-arousal and post-arousal periods was evaluated on Changes in heart rate and heart rate variability parameters (SDNN, RMSSD, pNN50) during arousal onset (p=<0.05). Cortical arousals during sleep were associated with significant increases in heart rate and heart rate variability during arousal onset across all arousal etiologies, with more intense variations observed in females and during REM sleep.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: