Nature and Science of Sleep (Sep 2020)
Changes in Heart Rate Variability and Baroreflex Sensitivity During Daytime Naps
Abstract
Abdullah A AlQatari,1 Jawad A Alturki,1 Komail A Abdulali,1 Dawood A Alhumud,1 Mohammed A Alibrahim,1 Yaser A Alarab,1 Ayad M Salem,2 Talay Yar,2 Yousef D Alqurashi,3 Ahmed A Alsunni,2 Shoug Al Humoud3 1College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Respiratory Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Ahmed A AlsunniDepartment of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaTel +966535255577Email [email protected] and Objectives: Changes in autonomic cardiac activity during night sleep are well documented. However, there is limited information regarding changes in the autonomic cardiac profile during daytime naps. Heart rate variability (HRV) and baroreflex sensitivity (BRS) are reliable measures of autonomic cardiac activity. The purpose of this study was to determine the changes in HRV and BRS during daytime naps in healthy men.Methods: This was a cross-sectional study of 25 healthy men. Polysomnographic recording with electrocardiogram monitoring was conducted for all volunteers during a 50– 80 min nap between 3.30 pm and 5.30 pm. Five-minute segments during pre-nap wakefulness, non-rapid eye movement (NREM) sleep stages (N1, N2, and N3), rapid eye movement (REM) sleep stage, and post-nap wakefulness were used to measure changes in the variation in HRV parameters, including inter-beat interval (RR-interval), total spectral power (TP), high-frequency power (HF), low-frequency power (LF), and low frequency/high-frequency ratio (LF/HF). BRS was also measured for 10 min during pre- and post-nap wakefulness using finger arterial pressure measurement (Finometer Pro ®).Results: HRV increased significantly during NREM sleep compared with that during pre-nap wakefulness (p < 0.05), as reflected by RR-interval prolongation, higher HF, and increased HFnu (normalized units). Furthermore, there was a parallel reduction in TP, LF, and LF/HF ratio during NREM sleep, indicating parasympathetic predominance over cardiac autonomic activity. HF and HFnu were significantly reduced during REM sleep compared with that during NREM sleep (p < 0.05). BRS did not show significant differences between pre- and post-nap wakefulness.Conclusion: We observed a progressive increase in parasympathetic activity during daytime sleep as NREM sleep deepened compared with that during wakefulness and REM sleep. Daytime nap may have a favorable cardiovascular impact.Keywords: daytime naps, HRV, baroreflex sensitivity, polysomnography, autonomic activity