Heart rate variability during daytime naps in healthy adults: Autonomic profile and short-term reliability

Napping and heart rate variability in elite athletes

Sleep and autonomic nervous system (ANS) influence each other in a bidirectional fashion. Importantly, it has been proposed that sleep has a beneficial regulatory influence over cardiovascular activity, which is mostly controlled by autonomic regulation through the activity of sympathetic and parasympathetic pathways of the ANS. A well-established method to non-invasively assess cardiac autonomic activity is heart rate variability (HRV) analysis. We aimed to investigate the effect of a 40-min nap opportunity on HRV. Twelve professional basketball players randomly accomplished two conditions: 40-min nap (NAP) and control (CON). Nocturnal sleep and naps were monitored by actigraphic recording and sleep diaries. Total sleep time (TST), time in bed (TIB), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) were analyzed. HRV was analyzed in 5-min segments during quiet wake before and after each condition with controlled breathing. Were analysed high (HF) and low frequency (LF) bands, the standard deviation of NN interval (SDNN), HRV index and stress index (SI). Wellness Hooper index and Epworth Sleepiness Scale (ESS) were assessed before and after both conditions. There was no significant difference in TIB, TST, SE, WASO, and VAS between NAP and CON. A significant increase in SDNN, HRV index, and LF and a significant decrease in HF, SI, ESS, and Hooper's stress and fatigue scores were observed from pre- to post-nap. In conclusion, napping reduces sleepiness, stress and fatigue, and might provide an advantage by preparing the body for a much-required sympathetic comeback following peaceful rest.

The effects of acute exercise and a nap on heart rate variability and memory in young sedentary adults

Recent evidence suggests that the autonomic nervous system can contribute to memory consolidation during sleep. Whether fluctuations in cardiac autonomic activity during sleep following physical exercise contribute to the process of memory consolidation has not been studied. We assessed the effects of a non-rapid eye movement (NREM) nap following acute exercise on cardiac autonomic regulation assessed with heart rate variability (HRV) to examine if HRV influences memory processes. Fifty-six (59% female) healthy young adults (23.14 ± 3.74 years) were randomly allocated to either the exercise plus nap (ExNap, n = 27) or nap alone (NoExNap, n = 29) groups. The ExNap group performed a 40-minute moderate-intensity cycling, while the NoExNap group was sedentary prior to learning 45 neutral pictures for a later test. Subsequently, participants underwent a 60-minute NREM nap while measuring EKG, followed by a visual recognition test. Our results indicated that heart rate did not significantly differ between the groups (p = .243), whereas vagally mediated HRV indices were lower in the ExNap group compared to the NoExNap group (p < .05). There were no significant differences in sleep variables between the groups (p > .05). Recognition accuracy was significantly higher in the ExNap group than in the NoExNap group (p = .027). In addition, the recognition accuracy of the ExNap group was negatively associated with vagally mediated HRV (p < .05). Pre-nap acute exercise appears to attenuate parasympathetic activity and to alter the relationship between memory and cardiac autonomic activity.

REM-OSA as a Tool to Understand Both the Architecture of Sleep and Pathogenesis of Sleep Apnea-Literature Review

Sleep is a complex physiological state, which can be divided into the non-rapid eye movement (NREM) phase and the REM phase. Both have some unique features and functions. This difference is best visible in electroencephalography recordings, respiratory system activity, arousals, autonomic nervous system activity, or metabolism. Obstructive sleep apnea (OSA) is a common condition characterized by recurrent episodes of pauses in breathing during sleep caused by blockage of the upper airways. This common condition has multifactorial ethiopathogenesis (e.g., anatomical predisposition, sex, obesity, and age). Within this heterogenous syndrome, some distinctive phenotypes sharing similar clinical features can be recognized, one of them being REM sleep predominant OSA (REM-OSA). The aim of this review was to describe the pathomechanism of REM-OSA phenotype, its specific clinical presentation, and its consequences. Available data suggest that in this group of patients, the severity of specific cardiovascular and metabolic complications is increased. Due to the impact of apneas and hypopneas predominance during REM sleep, patients are more prone to develop hypertension or glucose metabolism impairment. Additionally, due to the specific function of REM sleep, which is predominantly fragmented in the REM-OSA, this group presents with decreased neurocognitive performance, reflected in memory deterioration, and mood changes including depression. REM-OSA clinical diagnosis and treatment can alleviate these outcomes, surpassing the traditional treatment and focusing on a more personalized approach, such as using longer therapy of continuous positive airway pressure or oral appliance use.

Physiological response and physical performance after 40 min and 90 min daytime nap opportunities

This study aimed to examine the impact of 40-min and 90-min naps on performance in the 5-m shuttle run test (5mSRT) and on various physiological and perceptual measures. Sixteen male athletes (20 ± 3 years, 173 ± 7 cm, 67 ± 7 kg) performed the 5mSRT after a 40-min nap (N40), after a 90-min nap (N90), and in a no-nap, control condition (N0). The 5mSRT involves six repetitions of 30 s of all-out exercise. Total distance (in the six repetitions) and highest distance (in a single repetition) in the 5mSRT were greater after naps than in N0 (p < 0.001), and the total distance, which reflects the anaerobic capacity, was greater in N90 than in N40 (p < 0.05). Physiological and perceptual responses were favourable in both nap conditions (p < 0.01), more so in N90 than in N40 (p < 0.05). Together, the results support the contention that physiological/perceptual responses after napping contribute to improved exercise performance and that longer naps are more effective.

Reliability of Heart Rate Variability During Stable and Disrupted Polysomnographic Sleep

Heart rate variability (HRV) is commonly used within sleep and cardiovascular research, yet HRV reliability across various sleep stages remains equivocal. The present study examined the reliability of frequency- and time-domain HRV within stage II (N2), slow wave (SWS), and rapid eye movement (REM) sleep during both stable and disrupted sleep. We hypothesized that high-frequency (HF) HRV would be reliable in all three sleep stages, low-frequency (LF) HRV would be reliable during N2 and SWS, and that disrupted sleep via spontaneous cortical arousals would decrease HRV reliability. Twenty-seven participants (11 male, 16 female, 26±1 years) were equipped with laboratory polysomnography for one night. Both frequency- and time-domain HRV were analyzed in two 5-10 minute blocks during multiple stable and disrupted sleep cycles across N2, SWS and REM sleep. HF HRV was highly correlated across stable N2 (r=0.839, p<0.001), SWS (r=0.765, p<0.001) and REM (r=0.881, p<0.001). LF HRV was moderate-to-highly correlated during stable cycles of N2 sleep (r=0.694, p < 0.001), SWS, (r=0.765, p < 0.001), and REM (r=0.699, p<0.001) sleep. When stable sleep was compared with disrupted sleep, both time- and frequency-domain HRV were reliable (α>0.90, p<0.05) in N2, SWS, and REM, with the exception of LF HRV during SWS (α=0.62, p=0.089). In conclusion, time- and frequency-domain HRV demonstrated reliability across stable N2, SWS and REM sleep, and remained reliable during disrupted sleep. These findings support the use of HRV during sleep as a tool for assessing cardiovascular health and risk stratification.

Effect of napping on a bean bag chair on sleep stage, muscle activity, and heart rate variability

Background

Although ample evidence has demonstrated that daytime napping is beneficial for health and cognitive performance, bedding for napping has not yet been scientifically investigated.

Objectives

To explore the effect of a bean bag chair on daytime napping and physiological parameters related to sleep.

Methods

Fourteen healthy participants were enrolled within the context of a randomized, single-blind, crossover study to evaluate the effects of a bean bag chair in comparison with those of a urethane chair manufactured to have a similar shape. Electroencephalogram, electromyogram, and heart rate variability were recorded and compared between wakefulness and napping.

Results

Electroencephalogram analyses revealed no significant differences in sleep architecture or frequency components; however, a significant decrease was found in electromyogram recordings in the trapezius muscle, which represents the neck region (p = 0.019). Additionally, a significant main effect of bedding in the low-frequency/high-frequency ratio (F[1,20] = 4.314, p = 0.037) was revealed.

Conclusions

These results suggest that napping in a bean bag chair may provide a comfortable napping environment involving muscle relaxation and proper regulation of the autonomic nervous function.

Exploring the Effect of Long Naps on Handball Performance and Heart Rate Variability

This study explored the effect of long naps on handball-related performance and assessed the role of the cardiac autonomic nervous system in this process. Eleven male collegiate handball players performed a repeated sequential trial consisting of a 20-m consecutive turnaround run, 10-m run with a load, and shooting the ball into a target. Participants were allocated randomly and sequentially to have a short (20 minutes) nap, long (60 minutes) nap, or no nap. The Pittsburgh Sleep Quality Index was used to assess regular sleep quality. Subjective sleepiness before and after napping was measured using the Karolinska Sleepiness Scale. Heart rate variability was recorded to assess cardiac autonomic nervous function during napping. The Pittsburgh Sleep Quality Index score was correlated with shot accuracy only after long naps (ρ=0.636, r=0.048). A negative correlation was observed between the root mean square of successive differences and average load run time (ρ=−0.929, p<0.001). Long napping was associated with a significant benefit on performance in athletes with poor sleep quality, implying a role of the autonomic nervous system in this regard. Our findings indicate the effect of sleep quality on the endurance and resistance of handball players.

Age-related losses in cardiac autonomic activity during a daytime nap

In healthy, young individuals, a reduction in cardiovascular output and a shift from sympathetic to parasympathetic (vagal) dominance is observed from wake into stages of nocturnal and daytime sleep. This cardiac autonomic profile, measured by heart rate variability (HRV), has been associated with significant benefits for cardiovascular health. Aging is associated with decreased nighttime sleep quality and lower parasympathetic activity during both sleep and resting. However, it is not known whether age-related dampening of HRV extends to daytime sleep, diminishing the cardiovascular benefits of naps in the elderly. Here, we investigated this question by comparing the autonomic activity profile between young and older healthy adults during a daytime nap and a similar period of wakefulness (quiet wake; QW). For each condition, from the electrocardiogram (ECG), we obtained beat-to-beat HRV intervals (RR), root mean square of successive differences between adjacent heart-beat-intervals (RMSSD), high-frequency (HF), low-frequency (LF) power, and total power (TP), HF normalized units (HFnu ), and the LF/HF ratio. As previously reported, young subjects showed a parasympathetic dominance during NREM, compared with REM, prenap rest, and WASO. Moreover, older, compared to younger, adults showed significantly lower vagally mediated HRV (measured by RMSSD, HF, HFnu ) during NREM. Interestingly, however, no age-related differences were detected during prenap rest or QW. Altogether, our findings suggest a sleep-specific reduction in parasympathetic modulation that is unique to NREM sleep in older adults.

[The effect of music embedded with binaural beats on heart rate parameters during nap]

OBJECTIVE

To test hypothesis that music embedded with binaural beats can boost activity of parasympathetic part of autonomic nervous system (PPANS) with the development of nap.

MATERIAL AND METHODS

The power of high-frequency component of heart rate variability spectrum computed on successive 2-minute intervals during 20-minute nap was a comparison criterion. The criterion was compared during nap accompanied by music with embedded binaural beats (stimulus condition) and nap in silence (control condition).

RESULTS AND CONCLUSION

Statistical comparison revealed the increase of PPANS activity during nap in stimulus condition vs. control condition. It is consistent with conclusions of other papers about positive effect of sound stimuli embedded with binaural beats on PPANS.

Autonomic Activity during a Daytime Nap Facilitates Working Memory Improvement

Recent investigations have implicated the parasympathetic branch of the autonomic nervous system in higher-order executive functions. These actions are purported to occur through autonomic nervous system's modulation of the pFC, with parasympathetic activity during wake associated with working memory (WM) ability. Compared with wake, sleep is a period with substantially greater parasympathetic tone. Recent work has reported that sleep may also contribute to improvement in WM. Here, we examined the role of cardiac parasympathetic activity during sleep on WM improvement in healthy young adults. Participants were tested in an operation span task in the morning and evening, and during the intertest period, participants experienced either a nap or wake. We measured high-frequency heart rate variability as an index of cardiac, parasympathetic activity during both wake and sleep. Participants showed the expected boost in parasympathetic activity during nap, compared with wake. Furthermore, parasympathetic activity during sleep, but not wake, was significantly correlated with WM improvement. Together, these results indicate that the natural boost in parasympathetic activity during sleep may benefit gains in prefrontal executive function in young adults. We present a conceptual model illustrating the interaction between sleep, autonomic activity, and prefrontal brain function and highlight open research questions that will facilitate understanding of the factors that contribute to executive abilities in young adults as well as in cognitive aging.

Changes in Heart Rate Variability and Baroreflex Sensitivity During Daytime Naps

BACKGROUND 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 HF_nu (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 HF_nu 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.

Sleep – the yet underappreciated player in cardiovascular diseases: A clinical review from the German Cardiac Society Working Group on Sleep Disordered Breathing

Patients with a wide variety of cardiovascular diseases, including arterial and pulmonary hypertension, arrhythmia, coronary artery disease and heart failure, are more likely to report impaired sleep with reduced sleep duration and quality, and also, sometimes, sleep interruptions because of paroxysmal nocturnal dyspnoea or arrhythmias. Overall, objective short sleep and bad sleep quality (non-restorative sleep) and subjective long sleep duration are clearly associated with major cardiovascular diseases and fatal cardiovascular outcomes. Sleep apnoea, either obstructive or central in origin, represents the most prevalent, but only one, of many sleep-related disorders in cardiovascular patients. However, observations suggest a bidirectional relationship between sleep and cardiovascular diseases that may go beyond what can be explained based on concomitant sleep-related disorders as confounding factors. This makes sleep itself a modifiable treatment target. Therefore, this article reviews the available literature on the association of sleep with cardiovascular diseases, and discusses potential pathophysiological mechanisms. In addition, important limitations of the current assessment, quantification and interpretation of sleep in patients with cardiovascular disease, along with a discussion of suitable study designs to address future research questions and clinical implications are highlighted. There are only a few randomised controlled interventional outcome trials in this field, and some of the largest studies have failed to demonstrate improved survival with treatment (with worse outcomes in some cases). In contrast, some recent pilot studies have shown a benefit of treatment in selected patients with underlying cardiovascular diseases.

Timing between Cortical Slow Oscillations and Heart Rate Bursts during Sleep Predicts Temporal Processing Speed, but Not Offline Consolidation

Central and autonomic nervous system activities are coupled during sleep. Cortical slow oscillations (SOs; <1 Hz) coincide with brief bursts in heart rate (HR), but the functional consequence of this coupling in cognition remains elusive. We measured SO-HR temporal coupling (i.e., the peak-to-peak interval between downstate of SO event and HR burst) during a daytime nap and asked whether this SO-HR timing measure was associated with temporal processing speed and learning on a texture discrimination task by testing participants before and after a nap. The coherence of SO-HR events during sleep strongly correlated with an individual's temporal processing speed in the morning and evening test sessions, but not with their change in performance after the nap (i.e., consolidation). We confirmed this result in two additional experimental visits and also discovered that this association was visit-specific, indicating a state (not trait) marker. Thus, we introduce a novel physiological index that may be a useful marker of state-dependent processing speed of an individual.

Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents

Study Objectives

We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease.

Methods

Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group.

Results

All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude.

Conclusions

We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.

Procedural memory consolidation is associated with heart rate variability and sleep spindles

Sleep and memory studies often focus on overnight rather than long‐term memory changes, traditionally associating overnight memory change (OMC) with sleep architecture and sleep patterns such as spindles. In addition, (para‐)sympathetic innervation has been associated with OMC after a daytime nap using heart rate variability (HRV). In this study we investigated overnight and long‐term performance changes for procedural memory and evaluated associations with sleep architecture, spindle activity (SpA) and HRV measures (R‐R interval [RRI], standard deviation of R‐R intervals [SDNN], as well as spectral power for low [LF] and high frequencies [HF]). All participants (N = 20, M_age = 23.40 ± 2.78 years) were trained on a mirror‐tracing task and completed a control (normal vision) and learning (mirrored vision) condition. Performance was evaluated after training (R1), after a full‐night sleep (R2) and 7 days thereafter (R3). Overnight changes (R2‐R1) indicated significantly higher accuracy after sleep, whereas a significant long‐term (R3‐R2) improvement was only observed for tracing speed. Sleep architecture measures were not associated with OMC after correcting for multiple comparisons. However, individual SpA change from the control to the learning night indicated that only “SpA enhancers” exhibited overnight improvements for accuracy and long‐term improvements for speed. HRV analyses revealed that lower SDNN and LF power was associated with better OMC for the procedural speed measure. Altogether, this study indicates that overnight improvement for procedural memory is specific for spindle enhancers, and is associated with HRV during sleep following procedural learning.

Napping Improves HRV in Older Patients With Cardiovascular Risk Factors

Heart rate variability (HRV), especially increased high frequency (HF), has been reported to provide clinically useful prognostic information regarding cardiovascular disease. Napping is an excellent sleep management strategy in older adults. This study was conducted to clarify the effect of napping on HRV in older adult patients with cardiovascular risk factors. The patients were divided into two groups: one group of 32 patients who reported napping (nap group) and another group of 45 patients who did not report napping (nonnap group). The HRV was calculated in terms of the HF component over 24 hr during wakefulness, sleep, and 1 hr after sleep onset. The HF in the nap group was significantly higher than that in the nonnap group during all times measured. In addition, napping was a significant predictor of increased HF. This study shows the effectiveness of napping in the daily lives of patients with cardiovascular risk factors.

Coupling of autonomic and central events during sleep benefits declarative memory consolidation

While anatomical pathways between forebrain cognitive and brainstem autonomic nervous centers are well-defined, autonomic-central interactions during sleep and their contribution to waking performance are not understood. Here, we analyzed simultaneous central activity via electroencephalography (EEG) and autonomic heart beat-to-beat intervals (RR intervals) from electrocardiography (ECG) during wake and daytime sleep. We identified bursts of ECG activity that lasted 4-5 s and predominated in non-rapid-eye-movement sleep (NREM). Using event-based analysis of NREM sleep, we found an increase in delta (0.5-4 Hz) and sigma (12-15 Hz) power and an elevated density of slow oscillations (0.5-1 Hz) about 5 s prior to peak of the heart rate burst, as well as a surge in vagal activity, assessed by high-frequency (HF) component of RR intervals. Using regression framework, we show that these Autonomic/Central Events (ACE) positively predicted post-nap improvement in a declarative memory task after controlling for the effects of spindles and slow oscillations from sleep periods without ACE. No such relation was found between memory performance and a control nap. Additionally, NREM ACE negatively correlated with REM sleep and learning in a non-declarative memory task. These results provide the first evidence that coordinated autonomic and central events play a significant role in declarative memory consolidation.

Effects of a Short Daytime Nap on Shooting and Sprint Performance in High-Level Adolescent Athletes

PURPOSE

To investigate the sport-specific performance effect of a brief afternoon nap on high-level Asian adolescent student-athletes who were habitually short sleepers.

METHODS

Participants were randomly assigned to a nap or nonnap (reading) condition. In the first study, 12 male shooters (13.8 [1.0] y) performed a shooting assessment (20 competition shots) with heart-rate variability monitored during the assessment. In the second study, 19 male track-and-field athletes (14.8 [1.1] y) performed a 20-m sprint-performance assessment. Subjective measures of sleepiness and alertness were obtained in both studies.

RESULTS

The brief nap had no effect on any measure of shooting performance (P > .05) or autonomic function (P > .05) in shooters. However, the fastest 20-m sprint times increased significantly (P < .05) from 3.385 (0.128) s to 3.411 (0.143) s, with mean 2-m times trending toward significance (P < .1) among the track-and-field athletes. No significant differences were observed in any other measures.

CONCLUSIONS

The results of the research indicate varying effects of naps between sport-specific performance measures. Napping had no effect on shooting performance, whereas a negative effect existed in 20-m sprint performance, potentially due to sleep inertia. Considering these findings, some caution is warranted when advocating naps for adolescent athletes.

Comparing the cardiac autonomic activity profile of daytime naps and nighttime sleep

Heart rate variability (HRV) is a reliable technique to evaluate autonomic activity and shows marked changes across a night of sleep. Previous nighttime sleep findings report changes in HRV during non-rapid eye movement sleep (NREM), which have been associated with cardiovascular health benefits. Daytime sleep, however, has been linked with both positive and negative cardiovascular outcomes. Yet, no studies have directly compared HRV profiles during an ecologically-valid daytime nap in healthy, well-rested adults to that of nighttime sleep. Using a within-subjects design, 32 people took a daytime nap and slept overnight in the lab at least one week apart; both sleep sessions had polysomnography, including electrocardiography (ECG), recorded. We measured inter-beat intervals (RR), total power (TP), low frequency power (LF; .04-.15 Hz), and high frequency power (HF; .15-.40 Hz) components of HRV during NREM and rapid eye movement (REM) sleep. Compared to the nap, we found longer RR intervals and decreased heart rate during the night for both Stage 2 and SWS and increased TP, LF and HF power during nighttime Stage 2 sleep only; however, no differences in the LFHF ratio or normalized HF power were found between the nap and the night. Also, no differences in REM sleep between the nap and night were detected. Similar relationships emerged when comparing the nap to one cycle of nighttime sleep. These findings suggest that longer daytime naps, with both SWS and REM, may provide similar cardiovascular benefits as nocturnal sleep. In light of the on-going debate surrounding the health benefits and/or risks associated with napping, these results suggest that longer daytime naps in young, healthy adults may support cardiac down-regulation similar to nighttime sleep. In addition, napping paradigms may serve as tools to explore sleep-related changes in autonomic activity in both healthy and at-risk populations.

Improving the Test-Retest Reliability of Resting State fMRI by Removing the Impact of Sleep

Resting state functional magnetic resonance imaging (rs-fMRI) provides a powerful tool to examine large-scale neural networks in the human brain and their disturbances in neuropsychiatric disorders. Thanks to its low demand and high tolerance, resting state paradigms can be easily acquired from clinical population. However, due to the unconstrained nature, resting state paradigm is associated with excessive head movement and proneness to sleep. Consequently, the test-retest reliability of rs-fMRI measures is moderate at best, falling short of widespread use in the clinic. Here, we characterized the effect of sleep on the test-retest reliability of rs-fMRI. Using measures of heart rate variability (HRV) derived from simultaneous electrocardiogram (ECG) recording, we identified portions of fMRI data when subjects were more alert or sleepy, and examined their effects on the test-retest reliability of functional connectivity measures. When volumes of sleep were excluded, the reliability of rs-fMRI is significantly improved, and the improvement appears to be general across brain networks. The amount of improvement is robust with the removal of as much as 60% volumes of sleepiness. Therefore, test-retest reliability of rs-fMRI is affected by sleep and could be improved by excluding volumes of sleepiness as indexed by HRV. Our results suggest a novel and practical method to improve test-retest reliability of rs-fMRI measures.

Cardiac autonomic activity during daytime nap in young adults

The current study investigated both sympathetic and vagal autonomic patterns during a daytime sleep in 25 healthy adults (23.2 ± 2.4 years). Pre-ejection period (PEP; related inversely to beta-adrenergic sympathetic activity), the interval between consecutive R-waves (RR) and frequency-domain heart rate variability (HRV) were computed during pre-nap wakefulness and undisturbed sleep stages. Results showed sleep-related changes in RR and HRV measures, whereas PEP decreased significantly from pre-nap to sleep, showing no differences across sleep stages. Moreover, pre-nap PEP and HFnu (the normalized unit of the high-frequency component of HRV) were associated negatively with sleep latency and wake after sleep onset. These results indicate a marked autonomic output reduction during daytime sleep, with different stage-dependent fluctuations for sympathetic and vagal activity. Importantly, pre-nap autonomic activity seems to modulate subsequent sleep quality.

Autonomic activity during sleep predicts memory consolidation in humans

Throughout history, psychologists and philosophers have proposed that good sleep benefits memory, yet current studies focusing on the relationship between traditionally reported sleep features (e.g., minutes in sleep stages) and changes in memory performance show contradictory findings. This discrepancy suggests that there are events occurring during sleep that have not yet been considered. The autonomic nervous system (ANS) shows strong variation across sleep stages. Also, increases in ANS activity during waking, as measured by heart rate variability (HRV), have been correlated with memory improvement. However, the role of ANS in sleep-dependent memory consolidation has never been examined. Here, we examined whether changes in cardiac ANS activity (HRV) during a daytime nap were related to performance on two memory conditions (Primed and Repeated) and a nonmemory control condition on the Remote Associates Test. In line with prior studies, we found sleep-dependent improvement in the Primed condition compared with the Quiet Wake control condition. Using regression analyses, we compared the proportion of variance in performance associated with traditionally reported sleep features (model 1) vs. sleep features and HRV during sleep (model 2). For both the Primed and Repeated conditions, model 2 (sleep + HRV) predicted performance significantly better (73% and 58% of variance explained, respectively) compared with model 1 (sleep only, 46% and 26% of variance explained, respectively). These findings present the first evidence, to our knowledge, that ANS activity may be one potential mechanism driving sleep-dependent plasticity.