Sleep state and vagal regulation of heart period patterns in the human newborn: an extension of the polyvagal theory.

The influence of sleep state (i.e., active and quiet) on heart period, heart period variability, respiratory sinus arrhythmia (RSA), and the coupling between RSA and heart period was evaluated in 24 healthy full-term newborns. Electrocardiogram (ECG) data were collected, and sleep state was coded 1 hr after feeding until at least 10 min of data were collected in states of active and quiet sleep. ECG data were analyzed for the first five continuous minutes of each sleep state. Relative to active sleep, quiet sleep was associated with significantly higher amplitude RSA, lower heart period variability, and longer heart periods. Because RSA amplitude reflects the functional output of vagal pathways originating in the nucleus ambiguus, it was hypothesized that sleep state would influence how these vagal pathways regulate instantaneous changes in heart period. A new method, evaluating the instantaneous coupling of RSA and heart period, demonstrated that coupling was significantly greater during active sleep. The neurophysiological explanation extends the polyvagal theory to include potential cortical-brain stem connections.

[1]  J. Cacioppo,et al.  The metrics of cardiac chronotropism: biometric perspectives. , 1995, Psychophysiology.

[2]  G. Berntson,et al.  Autonomic interactions and chronotropic control of the heart: heart period versus heart rate. , 1996, Psychophysiology.

[3]  K. Connolly,et al.  The Relation of Respiration Rate and Heart Rate to Sleep States in the Human Newborn , 1971, Developmental medicine and child neurology.

[4]  R Lazzara,et al.  Heart rate variability during specific sleep stages. A comparison of healthy subjects with patients after myocardial infarction. , 1995, Circulation.

[5]  M. Sterman,et al.  Polygraphic Studies of Normal Infants during the First Six Months of Life. I. Heart Rate and Variability as a Function of State , 1976, Pediatric Research.

[6]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[7]  M. Sterman,et al.  Effects of feeding on state and cardiac regulation in the infant. , 1977, Developmental psychobiology.

[8]  J. Murray,et al.  Cardiorespiratory control. , 1977, The American review of respiratory disease.

[9]  S. Porges.  Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory. , 1995, Psychophysiology.

[10]  R. Uauy,et al.  Treatment of severe apnea in prematures with orally administered theophylline. , 1975, Pediatrics.

[11]  D. Hopkins,et al.  Viscerotopic representation of the upper alimentary tract in the medulla oblongata in the rat: The nucleus ambiguus , 1987, The Journal of comparative neurology.

[12]  K. Spyer,et al.  Two types of vagal preganglionic motoneurones projecting to the heart and lungs , 1978, The Journal of physiology.

[13]  S. Porges,et al.  Vagal regulation during bottle feeding in low-birthweight neonates: support for the gustatory-vagal hypothesis. , 1997, Developmental psychobiology.

[14]  H. Prechtl,et al.  Organization of Physiological Parameters in Normal and Neurologically Abnormal Infants , 1969, Neuropadiatrie.

[15]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[16]  J. Saul,et al.  Infants Tolerate Spinal Anesthesia with Minimal Overall Autonomic Changes: Analysis of Heart Rate Variability in Former Premature Infants Undergoing Hernia Repair , 1995, Anesthesia and analgesia.

[17]  P. Grossman,et al.  Respiratory Sinus Arrhythmia and Parasympathetic Cardiac Control: Some Basic Issues Concerning Quantification, Applications and Implications , 1986 .

[18]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[19]  R. Tarazi,et al.  Assessment of parasympathetic control of heart rate by a noninvasive method. , 1984, The American journal of physiology.

[20]  B. J. Casey,et al.  Heart rate variability during attention phases in young infants. , 1991, Psychophysiology.

[21]  J. Haselton,et al.  Bronchomotor vagal preganglionic cell bodies in the dog: an anatomic and functional study. , 1992, Journal of applied physiology.

[22]  S. Porges,et al.  Neonatal responsivity to gustatory stimulation: The gustatory-vagal hypothesis** , 1993 .

[23]  Heart rate and sleep states in infants , 1994, Neurophysiologie Clinique/Clinical Neurophysiology.

[24]  S. Porges,et al.  Infant regulation of the vagal "brake" predicts child behavior problems: a psychobiological model of social behavior. , 1996, Developmental psychobiology.