Heart rate variability and anxious arousal: Unique relations with sleep‐related problems in stress‐exposed adolescents

Feasibility of recruiting adolescents into a prospective cohort study of the effects of social isolation during COVID-19

BACKGROUND

Social connection and loneliness in adolescence are increasingly understood as critical influences on adult mental and physical health. The unique impact of the social isolation imposed by the COVID-19 lockdown on emerging adults is therefore expected to be especially profound. We sought to investigate the feasibility of using ecological momentary assessment (EMA) and wearable accelerometers to characterize the effects of social isolation and/or loneliness experienced by adolescents during the COVID-19 pandemic.

METHODS

We recruited 19 participants aged 13-18 from an Adolescent Medicine practice in Atlanta, GA. Participants completed surveys at baseline and throughout a 2-week study period using EMA regarding their degree of social isolation, loneliness, family functioning, school climate, social media use, and COVID-19 experiences surrounding their physical, mental, and social domains. Six participants agreed to wear an activity tracker and heart rate measurement device for 14 days to monitor their emotional state and physical health. Participant feedback was collected via open-ended exit interviews. Feasibility of recruitment/retention, adherence, and outcome measures were investigated. Implementation was also assessed by evaluating the barriers and facilitators to study delivery. Associations between the social isolation and loneliness variables and all other variables were performed with univariate linear regression analysis with significance set at p < 0.05. The progression criteria were a recruitment rate of > 30% and a retention rate of > 80%.

RESULTS

Progression criteria were met for recruitment (76%) of participants, but not retention (38%). Adherence to EMA survey completion was highly variable with only 54% completing ≥ 1 survey a day, and accelerometry use was not feasible. Social isolation was significantly correlated with lower school climate, higher COVID-19 experiences, higher depression scores, and lower sleep quality. Loneliness also showed a significant correlation with all these factors except COVID-19 experiences.

CONCLUSIONS

EMA and wearable accelerometer use was not feasible in this longitudinal study of adolescents during the COVID-19 pandemic. Future research should further investigate barriers to conducting long-term research with adolescents and the potential effects of the pandemic on subject recruitment and retention.

A bibliometric analysis of insomnia in adolescent

Background

The negative effects of insomnia on adolescents' development, academic performance, and quality of life place a burden on families, schools, and society. As one of the most important research directions for insomnia, adolescent insomnia has significant research value, social value, and practical significance. Unfortunately, there is no bibliometric analysis in this field of study. This study aims to analyze published articles using bibliometrics, summarize the current research progress and hot topics in this field systematically and exhaustively, and predict the future direction and trend of research.

Methods

For this study, the Web of Science Core Collection (WoSCC) database was searched between 2002 and 2022 for publications related to adolescent insomnia. The R-bibliometrix, VOSViewer, and CiteSpace software were utilized for bibliometric analysis.

Results

This investigation included 2468 publications from 3102 institutions in 87 countries, led by China and the United States. This field of research has entered a period of rapid development since 2017. The journal with the most publications on adolescent insomnia is Sleep, which is also the most co-cited journal. American Journal of Psychology has the highest impact factor among the top 10 journals. These papers were written by 10605 authors; notably, Liu Xianchen emerged as the author with the highest frequency of publications, while Mary A. Carskadon was the most frequently co-cited author. Mental health and comorbid diseases were the main research directions in this field. "Depression," "anxiety," "mental health," "COVID-19," "stress," "quality of life," "heart rate variability," and "attention-deficit hyperactivity disorder" were hot spots and trends in this field at the current moment.

Conclusion

The research on adolescent insomnia has social value, research value, and research potential; its development is accelerating, and an increasing number of researchers are focusing on it. This study summarized and analyzed the development process, hot spots, and trends of adolescent insomnia research using bibliometric analysis, which identified the current hot topics in this field and predicted the development trend for the future.

The effect of using activity workstations on heart rate variability during complex cognitive tasks

ObjectivesThe purpose of the current study was to examine the effects of using an activity workstation on the physiological stress response as measured by heart rate variability while completing cognitively demanding tasks. Participants: Eleven college students (6 females; age: 19.4 ± 0.9 years) participated in the study. Methods: The participants completed three psychologically stressful cognitive tasks while seated at a traditional desk and while using an activity workstation. Heart rate variability was recorded and analyzed with power spectrum density and time-domain analysis. Results: Using activity workstations while completing stressful cognitive tasks did not negatively affect task performance. There was; however, a reduction in low frequency heart rate variability but no change in cardiac sympathovagal balance. Conclusion: The results indicate that using activity workstations while completing difficult tasks reduces sympathetic reactivity to stress in college students. This suggests that using activity workstations could provide a coping mechanism for stress.

Correspondence of parasympathetic-mediated heart rate variability derived from electrocardiogram and photoplethysmography signals in ethnically diverse adolescents

The reliable and valid assessment of heart rate variability (HRV) is important to understanding autonomic functioning in youth. However, use of electrocardiogram (ECG) signals to derive estimates of parasympathetic-mediated HRV may present logistical barriers in applied settings. Thus, this study investigated the concordance between high-frequency HRV [HF-HRV] and root mean square of successive differences [RMSSD] derived from ECG and photoplethysmography (PPG) signals during a video baseline, resting baseline, and mental arithmetic among an ethnically diverse sample of ninety-six youths (M_age = 13.84; 51% male; 62.5% ethnic minority). Results showed moderate to almost perfect agreement between PPG- and ECG- derived HF-HRV and RMSSD for video and resting baselines (Lin's correlations ranged from 0.93 to 0.99) and limits of agreement (LoA) ranging from -0.48 to 0.58 (HF-HRV) and - 11.37 to 9.32 (RMSSD). Conversely, we found poor to moderate agreement for the mental arithmetic task (Lin's correlations ranged from 0.88 to 0.91) and LoA ranging from -0.68 + 0.94 (HF-HRV) and - 17.58 + 20.69 (RMSSD), though we did find ethnic minority youth had higher and moderate Lin's correlations (0.93 to 0.94). Overall, there was a bias towards higher HF-HRV and RMSSD values with PPG. Findings suggest that PPG-derived HF-HRV and RMSSD may be viable alternatives for ECG in baseline conditions, but tasks requiring movement or eliciting mild stress responses may result in less than perfect values and missing data patterns. It is imperative that future studies replicate these findings in other ethnically diverse youth samples and expand to younger children and applied settings.

Greater adolescent tiredness is related to more emotional arousal during a hyperventilation task: An area under the curve approach

INTRODUCTION

Approximately 36% of adolescents report sleep problems (Crowley et al., 2018). Understanding the relation between sleep and emotional experience is crucial in understanding the high incidence of mental health concerns during adolescence. The current study sought to expand understanding in the area by testing the hypothesis that baseline tiredness ratings would predict greater emotional arousal and negative valence across the course of emotional response elicited by a voluntary hyperventilation procedure.

METHODS

A community sample of 110 youth (10-18 years; 47.8% girls) provided baseline tiredness ratings and ratings of emotional valence and arousal, 2 min before, immediately after, and 3 min after a hyperventilation task. The area under the curve (AUC) was calculated using the repeated measures of valence and arousal, and correlations between the response curves and baseline tiredness were examined.

RESULTS AND CONCLUSIONS

Findings indicated baseline tiredness was positively associated with AUC arousal (r = 0.23), but not valence. This suggests daytime tiredness is associated with the degree of emotional arousal elicited by a psychobiological stressor. By extension, adolescents may experience more arousing emotional reactions when tired, and thus the common sleep deprivation observed during this developmental period may increase risk for mental health problems associated with elevated emotional reactivity.

Depressive symptoms among stress-exposed youth: Relations with tonic and phasic indices of autonomic functioning

Theoretical models of adolescent depression postulate that one possible individual vulnerability factor for the development of depressive symptoms is autonomic dysregulation. However, there is limited and mixed support for these models among ethnically diverse and higher risk stress-exposed youth. Therefore, this study investigated the relations between both tonic and phasic indices of parasympathetic autonomic functioning (i.e., resting high-frequency heart rate variability [HF-HRV] and root mean square of successive differences [RMSSD]; HF-HRV and RMSSD reactivity to a mental arithmetic stressor) and depressive symptoms among 80 severely stress-exposed youth (51% female; 11-17 years of age) from diverse backgrounds (61.3% ethnic minority; caregiver-reported median family income = $20,000-$49,999 per year). Results demonstrated that lower resting HF-HRV and RMSSD, but not HF-HRV and RMSSD reactivity, was associated with greater youth depressive symptoms. Our findings suggest that lower resting parasympathetic autonomic functioning may be a potential vulnerability factor of depressive symptoms among stress-exposed youth, instead of specific emotional responses to stressors. These findings will need to be replicated in larger samples of stress-exposed youth and youth at higher risk for or exhibiting clinical levels of depressive symptoms to better elucidate relations with autonomic functioning and depressive symptoms among adolescents.