Abstract
There have been numerous studies on the relationship between sleep and depression, as well as the relationship between sleep and depression, and heart rate variability (HRV), respectively. Even so, few studies have combined 24-h HRV analysis to study sleep quality and depressive symptoms. The purpose of this cross-sectional study was to investigate the relationship between depressed symptoms, sleep quality, and 24-h HRV in medical students. The particiants were all students at a medical university in Guangdong province, China. A total of 74 college students participated. They were asked to complete a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), the Positive and Negative Affect Scale (PANAS), and 24-h ECG monitoring. The results showed that 41.7% of the medical students had poor sleep quality, with higher levels of depressive symptoms and more negative emotions, and there was no difference in 24-h HRV indices between the low PSQI group and the high one. Correlation analysis showed that there was a significant relationship between sleep quality and depressive symptoms (r = 0.617), but the relationship between 24-h HRV indices and PSQI global scores, BDI scores were not significant. However, the correlation analysis of PSQI components and 24-h HRV showed that sleep disturbance was significantly negatively correlated with SDNN and LF in waking period (r = −0.285, −0.235), and with SDNN in sleeping period (r = −0.317). In general, the sleep disturbance in PSQI components can sensitively reflect the relationship between sleep quality and 24-h HRV of medical students. Individuals with higher sleep disturance may have lower SDNN during awake period and bedtime period, and lower LF in awake period. Twenty-four hour HRV has certain application value in clinical sleep quality monitoring, and its sensitivity and specificity in clinical application and daily life are still worth further investigation.
Highlights
Heart rate variability (HRV) is an important indicator of autonomic nervous system activity, and has been paid more and more attention for its objective, convenient, non-invasive, and sensitive characteristics
Spearman correlations were used to explore the relationship between sleep quality, depressive symptoms, and HRV during awake period.We found that the score of Sleep disturbance is negatively correlated with standard deviation of the NN (SDNN) and low frequency components (LF), and positively correlated with Beck Depression Inventory-II (BDI-II) (r = 0.372, p < 0.01) during awake period
This study found that [1] Correlation analysis found that the Pittsburgh Sleep Quality Index (PSQI) global scores was positively correlated with the BDIII scores, that is, the lower the sleep quality, the higher the level of depressive symptoms
Summary
Heart rate variability (HRV) is an important indicator of autonomic nervous system activity, and has been paid more and more attention for its objective, convenient, non-invasive, and sensitive characteristics. Heart rate variability analysis methods mainly include time domain and frequency domain. Low HRV is thought to be a marker for a number of mental health problems, including the severity of psychiatric disorders such as insomnia, depression, and anxiety [2,3,4,5,6,7,8,9,10]. In terms of time domain indices, standard deviation of the NN (SDNN), root mean square of R–R-intervals, (RMSSD) or the ratio of adjacent R–R intervals to total R–R intervals (pNN50) was lower than that of normal control group. The effective functioning of this system has been associated with stronger phasic activity of vagus nerve efferent activity to the sino-atrial node of the heart, often termed cardiac vagal control (CVC)
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