Effects Of Selective Sleep Deprivation On Hemodynamics And Heart Rate Variability In Healthy Volunteers

Objective:To study the effects of acute selective(REM /SWS)sleep deprivation(SD)on hemodynamics and cardiovascular autonomic nervous system in healthy volunteers under the guidance of polysomnography monitoring(PSG).Methods: The total of 30 healthy volunteers(male: female =1:1,age 26.27�4.479 years)were included in this study.Each healthy volunteer was included in the trial for three consecutive days: Normal sleep on the first day,the second day of selective sleep deprivation(SWS/REM sleep)and normal sleep on the third day,the first day after normal sleep out each of the cases of healthy volunteers in the waking state have received continuous positive airway pressure CPAP(pressure of 0,10,15 cmh2o)and double level Bi PAP positive airway pressure(IPAP0,15,20 cmh2 o,EPAP4cm H2O)mode mechanical ventilation control the airway pressure,then adopt the method of randomized,controlled,Divided into the period of rapid eye movement(REM)sleep deprivation group(15)and slow wave sleep(SWS)deprivation group(15),in after sleep deprivation night sleep deprivation in SWS or awakened during REM sleep,deprived of all night three times,the volunteers intervene airway pressure control or sleep deprivation when simultaneous hemodynamic parameters and index of heart rate variability(HRV)collected and analysed.Hemodynamic indexes have heart rate(HR)output,stroke volume(SV),stroke volume index(SI),cardiac output(CO),cardiac index(CI),cardiac index(CPI),peripheral resistance(TPR)of the body,and the whole body peripheral resistance index(TPRI)and systolic blood pressure(SBP),diastolic blood pressure(DBP),index of microcirculation with percutaneous oxygen partial pressure(Pcto2)and percutaneous co2 partial pressure(Pctco2),Heart rate variability index is extremely low frequency(VLF),low frequency(LF),high frequency and low frequency/high frequency(HF)all(LF/HF),sinus cardiac RR interphase standard deviation(SDNN),total root mean square value of the phase difference between adjacent RR(RMSSD value),the phase difference between adjacent NN > 50ms(p NN50),percentage of scatter plot of short axis(SD1),the axis of the scatterplot(SD2).Results: 1.1 under CPAP and Bi PAP ventilation modes,there was no statistically significant change in SV and SI with the increase of pressure(P > 0.05),while HR,CI,CO and CPI decreased,and TPR and TPRI increased(P < 0.01).The change of ventilation pressure Pcto2 in the same mode was not statistically significant(P1 > 0.05),but Pcto2 in Bi PAP mode was higher than CPAP(P2 < 0.01).Pctco2 decreased in both ventilation modes(P1 < 0.01),but the decrease in Bi PAP mode was greater(P2 < 0.01).1.2 in the CPAP ventilation mode,HF and PNN50 increased gradually when the end-expiratory pressure increased from 0 cm H2 O to 15 cm H2O(P < 0.01).In Bi PAP ventilation mode,EPAP was fixed at 4cm H2 O.When IPAP gradually increased from 0cm H2 O to 20 cm H2O,HF,RMSSD and PNN50 increased,while LF/HF and SDNN decreased(P < 0.01).2.In all healthy volunteers,HR increased after deprivation compared with before deprivation(P < 0.05),and there was no statistically significant change in SI,CI,CPI and TPRI(P > 0.05).In the SWS sleep deprivation group,HR increased and SI decreased after sleep deprivation compared with before sleep deprivation(P < 0.05).There was no statistically significant change in CI,CPI and TPRI(P > 0.05).In the REM sleep deprivation group,HR,CI,CPI increased and TPRI decreased after deprivation compared with before deprivation(P < 0.05),and SI changes were not statistically significant(P > 0.05).After SWS and REM sleep deprivation,diastolic blood pressure increased after waking compared with that before sleep(P < 0.05).REM and SWS sleep deprivation were performed for 3 times.The maximum heart rate,minimum heart rate and average heart rate had no statistical significance(P > 0.05).Overall analysis of late sleep deprivation and normal sleep late heart rate variability: in the REM sleep deprivation group,changes in frequency domain and time domain analysis indexes were not statistically significant(P > 0.05),and changes in nonlinear analysis indexes SD1 and SD2 were not statistically significant(P > 0.05),and SD1/SD2 decreased in late sleep deprivation(P < 0.05).In the SWS sleep deprivation group,there was no statistically significant change in frequency domain analysis index,time domain analysis index and nonlinear analysis index(P > 0.05).5 minutes frequency domain analysis,compared with before deprivation after deprivation: all healthy volunteers statistical analysis,VLF,LF/HF increased,HF decreased(P < 0.05),LF changes were not statistically significant(P > 0.05).In the SWS sleep deprivation group,LF and LF/HF increased and HF decreased(P < 0.05),and VLF changes were not statistically significant(P > 0.05).The changes of VLF,LF,HF and LF/HF in the REM sleep deprivation group were not statistically significant(P > 0.05).3.According to sleep all night scatterplot nonlinear analysis characteristics of healthy volunteers are divided into two groups: first division(scatterplot nonlinear analysis SD1 / SD2 > 0.3)and group b(scatterplot nonlinear analysis SD1 / SD2 < 0.3),the first division: deprive 5 minutes before and after frequency domain analysis: after depriving reduced compared with before the deprivation of HF,LF/HF increase(P < 0.05),VLF,LF change without statistical significance(P > 0.05);Overall analysis of late sleep deprivation and normal sleep late heart rate variability: compared with normal sleep deprivation,LF/HF increased(P<0.05),VLF,LF,HF,SDNN,SDANN,RMSSD,PNN50 changes were not statistically significant(P > 0.05).Systolic and diastolic blood pressure increased after sleep deprivation(P < 0.05).Group b: frequency domain analysis of 5 minutes before and after deprivation: only VLF increased after sleep deprivation compared with before deprivation(P < 0.05).Overall analysis of late sleep deprivation and normal sleep late heart rate variability: there was no statistically significant change in frequency domain index and time domain index(P > 0.05).Diastolic blood pressure increased after sleep deprivation(P < 0.05),and there was no statistically significant change in systolic blood pressure(P > 0.05).Conclusion: 1.Changes in airway pressure caused by CPAP and Bi PAP can cause slight changes in hemodynamics and autonomic nerve activity in healthy volunteers;2.Acute SD is associated with increased sympathetic nerve and decreased parasympathetic cardiovascular regulation.Selective REM sleep deprivation may exacerbate cardiovascular physiological fragility during sleep deprivation;Sudden awakening from slow-wave sleep is associated with an increased risk of cardiovascular events.3.Nonlinear analysis of scatter plot in SD1/SD2 > 0.3 population with autonomic nerve function instability,HRV can be used as a non-invasive method to evaluate the interaction between sympathetic and parasympathetic nervous systems,and plays an important role in assessing the heart health of high-risk population.