Correlation Between Heart Rate Variability Of Insomniac Maintenance Hemodialysis Patients And Zi Wu Liu Zhu Time Rules: A Preliminary Study

ObjectiveThe present study aimed to investigate the relationship between the function of autonomic nervous system and quality of sleep by demonstrating the circadian rhythm of heart rate variability in maintenance hemodialysis patients (MHD) with insomnia; and to find out potential links between Zi Wu Liu Zhu Rules and the heart rate variability of hemodialysis patients with insomnia.MethodsWe measured heart rate variability (HRV) by time-domain index and frequeney-domain index with Holter and the severity of insomnia using Pittsburgh sleep quality index among 21 hemodialysis patients; Analysis of diurnal variation of heart rate variability in hemodialysis patients with insomnia according to Zi Wu Liu Zhu Rules was performed. Heart rate variability (HRV) in time-domain index and frequeney-domain index was compared between hemodialysis patients and healthy control group, and also between different levels of sleep quality. The characteristics of HRV change following Zi Wu Liu Zhu Rules was preliminarily demonstrated.ResultsAll statistical analysis was performed using SPSS 22. The SDNN and SDANN is significantly different between hemodialysis patients with insomnia and healthy samples. There was no significant difference of HRV in time-domain index and frequeney-domain index between patients with different levels of sleep quality, between patients on sleeping pills and those not on sleeping pills, and also between day and night in MHD patients. (P> 0.05)According to Zi Wu Liu Zhu time.rule, it seems that the diurnal variation of heart rate variability in hemodialysis patients are similar to the law of Ying Wei in TCM theory.Statistical analysis of the data by SPSS22. Some index of the heart rate variability (SDNN、SDANN) is significant different between hemodialysis patients with insomnia and healthy samples. There shows no significant difference of HRV in time -domain index and frequeney - domain index of different degree of insomnia and wether sleeping bills and diurnal variation in MHD. (P>0.05)ConclusionThe index of HRV in MHD patients suffering from insomnia are lower than healthy one.It means the balance between the sympathetic nervous system and the parasympathetic nervous system is broken. The autonomic nervous regulation of the heart are weaken. The circadian rhythm of HRV in MHD patients suffering from insomnia are disorders.The lowest index of HRV appeared in Yin hour and the peak time is Si hour. Which does not conform the variation of heart rate variability in healthy people. The HRV of healthy people are lower during the daytime and higher in the nighttime.To some extent,the HRV of MHD patients are rhythmic. There is no statistic evidence prove that sleep disorders aggravated the decrease of HRV in MHD patients. As can be seen, sleep disorders have a certain effect on the HRV of MHD patients according to the curve. There are many studies confirm that the decrease of HRV can be an independent predictor of cardiovascular events. Combine with the TCM, this study provide a new idea-"following the prognosis of a disease" through clinical method of time medicine.