Chapter 20
Sleep-Related Modulations of Heart
Rate Variability, ECG,
and Cardio-Respiratory Coupling
Thomas Penzel, Yaopeng Ma, Jan Krämer, Niels Wessel, Martin Glos,
Ingo Fietze, and Ronny P. Bartsch
Abstract Background: Integrated physiological systems following regular rhythms
are a prime example of biological oscillators. Such systems include the heart with an
oscillatory activity on a time scale of 1-second and the circadian pacemaker leading
to a close to 24 h sleep-wake rhythm. Other prominent physiological oscillations
each characterized by specific time scales are brain waves, respiration, blood pressure and vascular activity, and sleep-stage transitions with non-REM/REM cycles. In
the healthy organism, these oscillators interact with each other, and studying those
interactions during physiological transitions and in patients with disorders helps
to uncover and better understand the underlying mechanisms. Methods: In order
to investigate the coupling of these oscillators, sleep studies with cardiorespiratory
polysomnography are performed on persons with healthy sleep and with sleep disorders. Polysomnography includes the recording of the electrocardiogram (ECG), the
sleep-electroencephalogram (EEG), respiration, blood pressure/pulse wave, oxygen
saturation, and movement activity by means of electromyogram (EMG). The analysis is performed visually by sleep experts, and computer assisted with time domain,
frequency domain, and non-linear methodologies. Results: The parameters obtained
provide information on the regulation of the autonomic nervous system (ANS) during
sleep. The ANS is regulated totally different during slow-wave (non-REM) and REM
sleep. Beat-to-beat heart-rate variations allow us to estimate a scoring of sleep stages.
To some degree it is possible to track transitions from wakefulness to sleep by solely
analyzing heart-rate variations. ECG and heart rate analysis allow assessment of
T. Penzel (B) · M. Glos · I. Fietze
Interdisziplinäres Schlafmedizinisches Zentrum, Charitecentrum Für Pneumologie CC12, Charité
– Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
e-mail: thomas.penzel@charite.de
T. Penzel
Saratov State University, Saratov, Russia
Y. Ma · R. P. Bartsch
Department of Physics, Bar-Ilan-University, Ramat Gan, Israel
J. Krämer · N. Wessel
Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik,
Humboldt-Universität Berlin, Berlin, Germany
© Springer Nature Switzerland AG 2021
A. Stefanovska and P. V. E. McClintock (eds.), Physics of Biological
Oscillators, Understanding Complex Systems,
https://doi.org/10.1007/978-3-030-59805-1_20
311
Sleep-Related Modulations of Heart
Rate Variability, ECG,
and Cardio-Respiratory Coupling
Thomas Penzel, Yaopeng Ma, Jan Krämer, Niels Wessel, Martin Glos,
Ingo Fietze, and Ronny P. Bartsch
Abstract Background: Integrated physiological systems following regular rhythms
are a prime example of biological oscillators. Such systems include the heart with an
oscillatory activity on a time scale of 1-second and the circadian pacemaker leading
to a close to 24 h sleep-wake rhythm. Other prominent physiological oscillations
each characterized by specific time scales are brain waves, respiration, blood pressure and vascular activity, and sleep-stage transitions with non-REM/REM cycles. In
the healthy organism, these oscillators interact with each other, and studying those
interactions during physiological transitions and in patients with disorders helps
to uncover and better understand the underlying mechanisms. Methods: In order
to investigate the coupling of these oscillators, sleep studies with cardiorespiratory
polysomnography are performed on persons with healthy sleep and with sleep disorders. Polysomnography includes the recording of the electrocardiogram (ECG), the
sleep-electroencephalogram (EEG), respiration, blood pressure/pulse wave, oxygen
saturation, and movement activity by means of electromyogram (EMG). The analysis is performed visually by sleep experts, and computer assisted with time domain,
frequency domain, and non-linear methodologies. Results: The parameters obtained
provide information on the regulation of the autonomic nervous system (ANS) during
sleep. The ANS is regulated totally different during slow-wave (non-REM) and REM
sleep. Beat-to-beat heart-rate variations allow us to estimate a scoring of sleep stages.
To some degree it is possible to track transitions from wakefulness to sleep by solely
analyzing heart-rate variations. ECG and heart rate analysis allow assessment of
T. Penzel (B) · M. Glos · I. Fietze
Interdisziplinäres Schlafmedizinisches Zentrum, Charitecentrum Für Pneumologie CC12, Charité
– Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
e-mail: thomas.penzel@charite.de
T. Penzel
Saratov State University, Saratov, Russia
Y. Ma · R. P. Bartsch
Department of Physics, Bar-Ilan-University, Ramat Gan, Israel
J. Krämer · N. Wessel
Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik,
Humboldt-Universität Berlin, Berlin, Germany
© Springer Nature Switzerland AG 2021
A. Stefanovska and P. V. E. McClintock (eds.), Physics of Biological
Oscillators, Understanding Complex Systems,
https://doi.org/10.1007/978-3-030-59805-1_20
311