A quantitative comparison of different methods to detect cardiorespiratory coordination during night-time sleep

Background

The univariate approaches used to analyze heart rate variability have recently been extended by several bivariate approaches with respect to cardiorespiratory coordination. Some approaches are explicitly based on mathematical models which investigate the synchronization between weakly coupled complex systems. Others use an heuristic approach, i.e. characteristic features of both time series, to develop appropriate bivariate methods.

Objective

In this study six different methods used to analyze cardiorespiratory coordination have been quantitatively compared with respect to their performance (no. of sequences with cardiorespiratory coordination, no. of heart beats coordinated with respiration). Five of these approaches have been suggested in the recent literature whereas one method originates from older studies.

Results

The methods were applied to the simultaneous recordings of an electrocardiogram and a respiratory trace of 20 healthy subjects during night-time sleep from 0:00 to 6:00. The best temporal resolution and the highest number of coordinated heart beats were obtained with the analysis of 'Phase Recurrences'. Apart from the oldest method, all methods showed similar qualitative results although the quantities varied between the different approaches. In contrast, the oldest method detected considerably fewer coordinated heart beats since it only used part of the maximum amount of information available in each recording.

Conclusions

The method of 'Phase Recurrences' should be the method of choice for the detection of cardiorespiratory coordination since it offers the best temporal resolution and the highest number of coordinated sequences and heart beats. Excluding the oldest method, the results of the heuristic approaches may also be interpreted in terms of the mathematical models.

     

Comparison of the two different approaches of orchiectomy in guinea pigs]

The results of orchiectomy conducted by the abdominal and scrotum routes were compared in guinea pigs. The operation time, surgical complication and incision healing were evaluated. About operation time, there was no distinct difference between two routes. In the abdominal route, the prognosis of this case was favorable. Also the healing of an incised wound was uneventful one week after the operation. While in the scrotum route, the tunica albuginea testis and the visceral vaginal tunic are thin, so that the risks of injuring the testis and/or scattering the contents of testis seem to be high. Inflammation of the scrotum was observed in 4 out of 5 guinea pigs, that were operated by scrotum route. From these results, the abdominal route method is highly recommended in the orchiectomy of guinea pigs.     

Heart rate variability in healthy humans during night sleep

Polysomnography has been performed and heart rate variability has been studied during night sleep in healthy young subjects of both sexes. It has been shown that, on average, a shift in autonomic support towards parasympathicotonia occurs during sleep, with a maximum at stages III and IV of NREM sleep. At stage II of NREM sleep and during REM sleep, a short-term activation of the sympathetic nervous system comparable to wakefulness is observed.     

Comparison of cardiorespiratory responses of moderately trained men and women using two different treadmill protocols

In practice, the Bruce protocol is the most commonly used treadmill protocol to assess maximal oxygen consumption (V(.-)O2max). It has been suggested that a running protocol (e.g., Astrand) may elicit a comparatively higher V(.-)O2max and different cardiorespiratory responses when applied to moderately trained runners. Thus, the purpose of this study was to compare V(.-)O2max and other cardiorespiratory responses as elicited by the standard Bruce and a modified Astrand treadmill protocol in moderately trained runners. Fifteen women (age = 21 years, height = 171.5 cm, weight = 63 kg, and body fat = 18%) and 15 men (age = 26 years, height = 177 cm, weight = 72 kg, and body fat = 9%) who were moderately trained runners completed a standard Bruce and modified Astrand protocol (random order), separated by approximately 7 days. Heart rate, Borg ratings of perceived exertion, blood pressure, and pulmonary gas exchange variables were measured during the exercise tests using standard laboratory procedures. This study revealed V(.-)O2max values between the Bruce protocol (51.3 +/- 11.6 ml x kg(-1) x min(-1)) and modified Astrand (51.5 +/- 10.9 ml x kg(-1) x min(-1)) were not significantly different in either the men or the women. However, the Bruce protocol elicited significantly higher maximum treadmill time in men and maximum respiratory exchange ratio (RERmax) and maximum minute ventilation (VEmax) values in both genders. Conversely, the modified Astrand elicited a higher HRmax. These data suggest that V(.-)O2max in both moderately trained men and women runners is independent of treadmill protocol despite differences in HRmax, RERmax, and VEmax.     

Directionality of coupling of physiological subsystems: age-related changes of cardiorespiratory interaction during different sleep stages in babies

Activity of many physiological subsystems has a well-expressed rhythmic character. Often, a dependency between physiological rhythms is established due to interaction between the corresponding subsystems. Traditional methods of data analysis allow one to quantify the strength of interaction but not the causal interrelation that is indispensable for understanding the mechanisms of interaction. Here we present a recently developed method for quantification of coupling direction and apply it to an important problem. Namely, we study the mutual influence of respiratory and cardiovascular rhythms in healthy newborns within the first 6 mo of life in quiet and active sleep. We find an age-related change of the coupling direction: the interaction is nearly symmetric during the first days and becomes practically unidirectional (from respiration to heart rhythm) at the age of 6 mo. Next, we show that the direction of interaction is mainly determined by respiratory frequency. If the latter is less than approximately 0.6 Hz, the interaction occurs dominantly from respiration to heart. With higher respiratory frequencies that only occur at very young ages, the dominating direction is less pronounced or even abolished. The observed dependencies are not related to sleep stage, suggesting that the coupling direction is determined by system-inherent dynamical processes, rather than by functional modulations. The directional analysis may be applied to other interacting narrow band oscillatory systems, e.g., in the central nervous system. Thus it is an important step forward in revealing and understanding causal mechanisms of interactions.     

Computer detection approaches for the identification of phasic electromyographic (EMG) activity during human sleep

BackgroundExamination of spontaneously occurring phasic muscle activity from the human polysomnogram may have considerable clinical importance for patient care, yet most attempts to quantify the detection of such activity have relied upon laborious and intensive visual analyses. We describe in this study innovative signal processing approaches to this issue.MethodsWe examined multiple features of surface electromyographic signals based on 16,200 individual 1-s intervals of low impedance sleep recordings. We validated which of those features most closely mirrored the careful judgments of trained human observers in making discriminations of the presence of short-lived (100–500 ms) phasic activity, and also examined which features provided maximal differences across 1-s intervals and which features were least susceptible to residual levels of amplifier noise.ResultsOur data suggested particularly promising and novel features (e.g., non-linear energy, 95th percentile of Spectral Edge Frequency) for developing automated systems for quantifying muscle activity during human sleep.ConclusionsThe EMG signals recorded from surface electrodes during sleep can be processed with techniques that reflect the visually based analyses of the human scorer but also offer potential for discerning far more subtle effects. Future studies will explore both the clinical utility of these techniques and their relative susceptibility to and/or independence from signal artifacts.     

三种腺样体手术方式治疗儿童OSAHS的临床观察

目的:探讨三种腺样体手术方式治疗儿童OSAHS临床疗效.方法:对86例经多导睡眠监测(PSG)确诊的OSAHS患儿(3-12岁)施行:全麻下经鼻内镜经口-鼻腺样体切除术、内镜辅助下射频消融术及传统的经口腺样体刮除术3术式,并对患儿进行术后的随访,观察术后夜间打鼾、鼻塞、张口呼吸等临床症状、腺样体残留等指标.结果:术后随访6-12个月.鼻内镜术后打鼾、鼻塞、张口呼吸等症状治愈率显著高于传统的腺样体刮除术(P＜0.01).传统的腺样体刮除术、鼻内镜下腺样体微波消融术,存在不同比例的腺样体残留,鼻内镜经口-鼻腺样体切除术,无腺样体残留.结论:手术切除肥大的腺样体是治疗儿童OSAHS的主要手段.鼻内镜辅助下腺样体切除术具有直视下操作、病变切除彻底、疗效明显、安全性高、创伤小及并发症少等优点.     

Dynamics of cardiorespiratory function in Standardbred horses during different intensities of constant-load exercise

Summary Six Standardbred horses were used to evaluate the time course of pulmonary gas exchange, ventilation, heart rate (HR) and acid base balance during different intensities of constant-load treadmill exercise. Horses were exercised at approximately 50%, 75% and 100% maximum oxygen uptake ( max) for 5 min and measurements taken every 30 s throughout exercise. At all work rates, the minute ventilation, respiratory frequency and tidal volume reached steady state values by 60 s of exercise. At 100% max, the oxygen consumption ( ) increased to mean values of approximately 130 ml/kg·min, which represents a 40-fold increase above resting . At the low and moderate work rates, showed no significant change from 30 s to 300 s of exercise. At the high work rate, the mean at 30 s was 80% of the value at 300 s. The HR showed no significant change over time at the moderate work rate but differing responses at the low and high work rates. At the low work rate, the mean HR decreased from 188 beats/min at 30 s to 172 beats/min at 300 s exercise, whereas at the high work rate the mean HR increased from 204 beats/min at 30 s to 221 beats/min at 300 s exercise. No changes in acid base status occurred during exercise at the low work rate. At the moderate work rate, a mild metabolic acidosis occurred which was nonprogressive with time, whereas the high work rate resulted in a progressive metabolic acidosis with a base deficit of 16 mmol/l by 300 s exercise. It is concluded that the kinetics of gas exchange during exercise are more rapid in the horse than in man, despite the relatively greater change in in the horse when going from rest to high intensity exercise.Symbols and abbreviations E minute ventilation - V _T tidal volume - oxygen uptake - carbon dioxide output - oxygen pulse - ventilatory equivalent for oxygen - ventilatory equivalent for carbon dioxide - R respiratory exchange ratio - HR heart rate - SBC standard bicarbonate - STPD standard temperature and pressure dry - BTPS body temperature and pressure saturated - arterial oxygen content - arteriovenous oxygen content difference - Rf respiratory frequency     

Duration of sleep inertia after napping during simulated night work and in extended operations

Due to the mixed findings of previous studies, it is still difficult to provide guidance on how to best manage sleep inertia after waking from naps in operational settings. One of the few factors that can be manipulated is the duration of the nap opportunity. The aim of the present study was to investigate the magnitude and time course of sleep inertia after waking from short (20-, 40- or 60-min) naps during simulated night work and extended operations. In addition, the effect of sleep stage on awakening and duration of slow wave sleep (SWS) on sleep inertia was assessed. Two within-subject protocols were conducted in a controlled laboratory setting. Twenty-four healthy young men (Protocol 1: n = 12, mean age = 25.1 yrs; Protocol 2: n = 12, mean age = 23.2 yrs) were provided with nap opportunities of 20-, 40-, and 60-min (and a control condition of no nap) ending at 02:00 h after ～20 h of wakefulness (Protocol 1 [P1]: simulated night work) or ending at 12:00 h after ～30 h of wakefulness (Protocol 2 [P2]: simulated extended operations). A 6-min test battery, including the Karolinska Sleepiness Scale (KSS) and the 4-min 2-Back Working Memory Task (WMT), was repeated every 15 min the first hour after waking. Nap sleep was recorded polysomnographically, and in all nap opportunities sleep onset latency was short and sleep efficiency high. Mixed-model analyses of variance (ANOVA) for repeated measures were calculated and included the factors time (time post-nap), nap opportunity (duration of nap provided), order (order in which the four protocols were completed), and the interaction of these terms. Results showed no test x nap opportunity effect (i.e., no effect of sleep inertia) on KSS. However, WMT performance was impaired (slower reaction time, fewer correct responses, and increased omissions) on the first test post-nap, primarily after a 40- or 60-min nap. In P2 only, performance improvement was evident 45 min post-awakening for naps of 40 min or more. In ANOVAs where sleep stage on awakening was included, the test x nap opportunity interaction was significant, but differences were between wake and non-REM Stage 1/Stage 2 or wake and SWS. A further series of ANOVAs showed no effect of the duration of SWS on sleep inertia. The results of this study demonstrate that no more than 15 min is required for performance decrements due to sleep inertia to dissipate after nap opportunities of 60 min or less, but subjective sleepiness is not a reliable indicator of this effect. Under conditions where sleep is short, these findings also suggest that SWS, per se, does not contribute to more severe sleep inertia. When wakefulness is extended and napping occurs at midday (i.e., P2), nap opportunities of 40- and 60-min have the advantage over shorter duration sleep periods, as they result in performance benefits ～45 min after waking.     

Comparison of different approaches for dose response analysis

Characterizing an appropriate dose‐response relationship and identifying the right dose in a clinical trial are two main goals of early drug‐development. MCP‐Mod is one of the pioneer approaches developed within the last 10 years that combines the modeling techniques with multiple comparison procedures to address the above goals in clinical drug development. The MCP‐Mod approach begins with a set of potential dose‐response models, tests for a significant dose‐response effect (proof of concept, PoC) using multiple linear contrasts tests and selects the “best” model among those with a significant contrast test. A disadvantage of the method is that the parameter values of the candidate models need to be fixed a priori for the contrasts tests. This may lead to a loss in power and unreliable model selection. For this reason, several variations of the MCP‐Mod approach and a hierarchical model selection approach have been suggested where the parameter values need not be fixed in the proof of concept testing step and can be estimated after the model selection step. This paper provides a numerical comparison of the different MCP‐Mod variants and the hierarchical model selection approach with regard to their ability of detecting the dose‐response trend, their potential to select the correct model and their accuracy in estimating the dose response shape and minimum effective dose. Additionally, as one of the approaches is based on two‐sided model comparisons only, we make it more consistent with the common goals of a PoC study, by extending it to one‐sided comparisons between the constant and alternative candidate models in the proof of concept step.     

Performance, sleep and circadian phase during a week of simulated night work

The current study investigated changes in night-time performance, daytime sleep, and circadian phase during a week of simulated shift work. Fifteen young subjects participated in an adaptation and baseline night sleep, directly followed by seven night shifts. Subjects slept from approximately 0800 hr until they naturally awoke. Polysomnographic data was collected for each sleep period. Saliva samples were collected at half hourly intervals, from 2000 hr to bedtime. Each night, performance was tested at hourly intervals. Analysis indicated that there was a significant increase in mean performance across the week. In general, sleep was not negatively affected. Rather, sleep quality appeared to improve across the week. However, total sleep time (TST) for each day sleep was slightly reduced from baseline, resulting in a small cumulative sleep debt of 3.53 (SD = 5.62) hours. Finally, the melatonin profile shifted across the week, resulting in a mean phase delay of 5.5 hours. These findings indicate that when sleep loss is minimized and a circadian phase shift occurs, adaptation of performance can occur during several consecutive night shifts.     

The effects of a 30-min nap during night shift following a prophylactic sleep in the afternoon

Sleep and Biological Rhythms - The purpose of this study was to investigate the effects of a 30-min nap, during a simulated night shift environment, when a prophylactic daytime sleep was...     

Comparison of biometrical approaches for QTL detection in multiple segregating families

Detection of QTL in multiple segregating families possesses many advantages over the classical QTL mapping in biparental populations. It has thus become increasingly popular, and different biometrical approaches are available to analyze such data sets. We empirically compared an approach based on linkage mapping methodology with an association mapping approach. To this end, we used a large population of 788 elite maize lines derived from six biparental families genotyped with 857 SNP markers. In addition, we constructed genetic maps with reduced marker densities to assess the dependency of the performance of both mapping approaches on the marker density. We used cross-validation and resample model averaging and found that while association mapping performed better under high marker densities, this was reversed under low marker densities. In addition to main effect QTL, we also detected epistatic interactions. Our results suggest that both approaches will profit from a further increase in marker density and that a cross-validation should be applied irrespective of the biometrical approach.