Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment

Q: What are the key findings of this study?

Subjective sleep quality and resting HRV were largely unrelated in older adults with MCI, except for a correlation between HF nu and sleep efficiency.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Mild cognitive impairment (MCI) (n=42). Intervention: Poor subjective sleep quality (PSQI score > 5) vs. Good subjective sleep quality (PSQI score <= 5). Primary outcome: Correlation between resting state heart rate variability (HF nu) and habitual sleep efficiency (r = 0.314, p=0.048).

Q: What does this research mean for the field?

Subjective sleep quality is largely unrelated to resting-state heart rate variability in older adults with mild cognitive impairment. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Bernhard Grässler; Milos Dordevic; Fabian Herold; Sabine Darius; Corinna Langhans; Nicole Halfpaap; Berit K. Labott; Patrick Müller; Achraf Ammar; Beatrice Thielmann; Irina Böckelmann; Notger G. Müller; Anita Hökelmann

doi:10.3390/ijerph182413321

December 17, 2021International Journal of Environmental Research and Public HealthOpen Access

Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment

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Key result

Subjective sleep quality is largely unrelated to resting HRV in older adults with MCI.

r = 0.314
P=0.048
n=42

Figures

Why the study?

Sleep problems are linked to cardiovascular and neurodegenerative diseases, but the relationship between subjective sleep quality and cardiac autonomic control in individuals with mild cognitive impairment required investigation.

Is subjectively reported sleep quality (via PSQI) associated with objective resting state heart rate variability (HRV) in older adults with mild cognitive impairment?

Key Points

To investigate the relationship between subjectively reported sleep quality and objective measures of resting state cardiac autonomic regulation in older adults with mild cognitive impairment.
Conducted a cross-sectional study analyzing 42 participants with mild cognitive impairment aged 56 to 80 years (mean age 69.0 ± 5.5 years; 19 men, 23 women).
Assessed subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and evaluated cardiac autonomic function via resting state heart rate variability (HRV).
Participants with good sleep quality exhibited significantly higher mean resting heart rates than poor sleepers (p = 0.037; effect size d = 0.670).
A single significant positive correlation emerged between normalized high-frequency power (HF nu) and sleep efficiency (r = 0.314, p = 0.048).
No other significant correlations were detected between subjective sleep quality scores and resting heart rate variability parameters in the sample.

Study Design

Type

Cross-Sectional (n=42)

Multicenter

No

Structured PICO

Is subjectively reported sleep quality (via PSQI) associated with objective resting state heart rate variability (HRV) in older adults with mild cognitive impairment?

P

Population

42 older German-speaking adults (mean age 69.0 years, 54.8% female) with mild cognitive impairment and free of severe cardiac or other neurological diseases in a cross-sectional analysis.

E

Exposure

Subjective sleep quality assessment via the German version of the Pittsburgh Sleep Quality Index (PSQI; 19 participants classified as bad sleepers with PSQI score > 5) and 5-minute resting state heart rate variability (HRV) measurement via three-channel Holter-ECG

C

Comparator

Good sleepers (23 participants with PSQI score ≤ 5); comparison also performed between amnestic MCI (aMCI) and non-amnestic MCI (naMCI)

O

Outcome

Association between subjective sleep quality (PSQI global and component scores) and resting state cardiac autonomic control parameters (RMSSD, HF nu, non-linear index D2, and mean heart rate)surrogate

Main Result

Effect estimate: r = 0.314

p-value: p=0.048

In older adults with mild cognitive impairment, subjective sleep quality assessed by the PSQI is largely unrelated to short-term resting heart rate variability, suggesting a need for 24-hour HRV monitoring and objective sleep measurements in this population.

Limitations

Time delay (up to two weeks) between HRV recording and assessment of subjective sleep quality via PSQI
Short-term (5-minute) resting HRV recording rather than 24-hour recording, missing nighttime HRV and susceptible to acute confounding
Small sample size (n = 42), which may have limited statistical power
Reliance on subjective self-reported sleep quality (PSQI) rather than objective measures like polysomnography or actigraphy
Homogeneous, high-functioning MCI sample with high MMSE scores (25-30)
Time delay of up to two weeks between HRV recording and completion of the PSQI questionnaire
Short-term 5-minute resting HRV measurement provides only a snapshot of autonomic control rather than 24-hour or nighttime HRV
Small sample size (n=42) limiting statistical power to detect smaller associations
Use of subjective self-reported sleep measures (PSQI) without objective sleep evaluation such as polysomnography or actigraphy
Homogeneous, high-functioning MCI sample with high MMSE scores (25 to 30)

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Implication

Does not support PSQI as surrogate for resting HRV in MCI; leaves open value of objective sleep measures and 24-h recordings.

Abstract

Sleep problems can be caused by psychological stress but are also related to cardiovascular and neurodegenerative diseases. Improving lifestyle behaviors, such as good sleep hygiene, can help to counteract the negative effects of neurodegenerative diseases and to improve quality of life. The purpose of this cross-sectional study was to investigate the relationship between subjectively reported measures of sleep quality (via Pittsburgh Sleep Quality Index (PSQI)) and objective measures of cardiac autonomic control (via resting state heart rate variability (HRV)) among individuals with mild cognitive impairment (MCI). The PSQI and resting state HRV data of 42 MCI participants (69.0 ± 5.5; 56–80 years) were analyzed. Nineteen of the participants reported poor sleep quality (PSQI score > 5). Good sleepers showed higher resting heart rate than bad sleepers (p = 0.037; ES = 0.670). Correlation analysis showed a significant correlation between the parameter HF nu and sleep efficiency, contrasting the expected positive association between reduced HRV and poor sleep quality in healthy and individuals with specific diseases. Otherwise, there were no significances, indicating that measures of subjective sleep quality and resting HRV were not related in the present sample of MCI participants. Further research is needed to better understand the complex relationship between HRV and lifestyle factors (e.g., sleep) in MCI.

Discussion

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Cite This Study

Grässler et al. (2021) conducted a cross-sectional in Mild cognitive impairment (MCI) (n=42). Poor subjective sleep quality (PSQI score > 5) vs. Good subjective sleep quality (PSQI score <= 5) was evaluated on Correlation between resting state heart rate variability (HF nu) and habitual sleep efficiency (r = 0.314, p=0.048). Subjective sleep quality and resting HRV were largely unrelated in older adults with MCI, except for a correlation between HF nu and sleep efficiency.

synapsesocial.com/papers/6a7481f2f2cd31a1fadbd748 https://doi.org/10.3390/ijerph182413321

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Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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