Dynamics of Heart Rate and Sleep Stages in Normals and Patients with Sleep Apnea

Sleep is not just the absence of wakefulness but a regulated process with an important restorative function. Based on electroencephalographic recordings and characteristic patterns and waveforms we can distinguish wakefulness and five sleep stages grouped into light sleep, deep sleep, and rapid-eye-movement (REM) sleep. In order to explore the functions of sleep and sleep stages, we investigated the dynamics of sleep stages over the night and of heart-rate variability during the different sleep stages. Sleep stages and intermediate wake states have different distributions of their duration and this allows us to create a model for the temporal sequence of sleep stages and wake states. Heart rate is easily accessed with a high precision by the recording and analysis of the electrocardiogram (ECG). Heart-rate regulation is part of the autonomous nervous system and sympathetic tone is strongly influenced by the sleep stages.

[1]  A. Rechtschaffen A manual of standardized terminology, techniques and scoring system for sleep of human subjects , 1968 .

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

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

[4]  ColinE. Sullivan,et al.  REVERSAL OF OBSTRUCTIVE SLEEP APNOEA BY CONTINUOUS POSITIVE AIRWAY PRESSURE APPLIED THROUGH THE NARES , 1981, The Lancet.

[5]  R. Cohen,et al.  Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. , 1981, Science.

[6]  A J Block,et al.  Indications and standards for cardiopulmonary sleep studies. , 1985, Sleep.

[7]  G. Varoneckas,et al.  Components of the heart rhythm power spectrum in wakefulness and individual sleep stages. , 1986, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[8]  EICOSAPENTAENOIC ACID IN FAT , 1987 .

[9]  M A Sackner Indications and standards for cardiopulmonary sleep studies. , 1989, The American review of respiratory disease.

[10]  P. Lavie,et al.  Power spectrum analysis and heart rate variability in Stage 4 and REM sleep: evidence for state‐specific changes in autonomic dominance , 1993, Journal of sleep research.

[11]  M Chiodi,et al.  Different heart rate patterns in obstructive apneas during NREM sleep. , 1997, Sleep.

[12]  D. Rapoport,et al.  Detection of flow limitation with a nasal cannula/pressure transducer system. , 1998, American journal of respiratory and critical care medicine.

[13]  Larry S. Liebovitch,et al.  Fractals and Chaos Simplified for the Life Sciences , 1998 .

[14]  Crispin Jenkinson,et al.  Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial , 1999, The Lancet.

[15]  T Penzel,et al.  Sleep-related breathing disorder is an independent risk factor for systemic hypertension. , 1999, American journal of respiratory and critical care medicine.

[16]  A. Bunde,et al.  Sleep stage-dependent heart rate variability in patients with obstructive sleep apnea , 1999, Computers in Cardiology 1999. Vol.26 (Cat. No.99CH37004).

[17]  S. Havlin,et al.  Correlated and uncorrelated regions in heart-rate fluctuations during sleep. , 2000, Physical review letters.

[18]  D. Sornette Critical Phenomena in Natural Sciences: Chaos, Fractals, Selforganization and Disorder: Concepts and Tools , 2000 .

[19]  T. Penzel,et al.  Computer based sleep recording and analysis. , 2000, Sleep medicine reviews.

[20]  Mechanisms for Power Laws , 2000 .

[21]  S. Havlin,et al.  Detecting long-range correlations with detrended fluctuation analysis , 2001, cond-mat/0102214.

[22]  Armin Bunde,et al.  The Science of Disasters , 2002 .

[23]  Crispin Jenkinson,et al.  Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial , 2002, The Lancet.

[24]  L. Amaral,et al.  Dynamics of sleep-wake transitions during sleep , 2001, cond-mat/0112280.

[25]  Max Hirshkowitz,et al.  Normal human sleep: an overview. , 2004, The Medical clinics of North America.