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Heart rate variability during sleep in children with autism spectrum disorder

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Abstract

Purpose

Autonomic dysfunction has been reported in autism spectrum disorders (ASD). Less is known about autonomic function during sleep in ASD. The objective of this study is to provide insight into the autonomic cardiovascular control during different sleep stages in ASD. We hypothesized that patients with ASD have lower vagal and higher sympathetic modulation with elevated heart rate, as compared to typical developing children (TD).

Methods

We studied 21 children with ASD and 23 TD children during overnight polysomnography. Heart rate and spectral parameters were calculated for each vigilance stage during sleep. Data from the first four sleep cycles were used to avoid possible effects of different individual sleep lengths and sleep cycle structures. Linear regression models were applied to study the effects of age and diagnosis (ASD and TD).

Results

In both groups, HR decreased during non-REM sleep and increased during REM sleep. However, HR was significantly higher in stages N2, N3 and REM sleep in the ASD group. Children with ASD showed less high frequency (HF) modulation during N3 and REM sleep. LF/HF ratio was higher during REM. Heart rate decreases with age at the same level in ASD and in TD. We found an age effect in LF in REM different in ASD and TD.

Conclusion

Our findings suggest possible deficits in vagal influence to the heart during sleep, especially during REM sleep. Children with ASD may have higher sympathetic dominance during sleep but rather due to decreased vagal influence.

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Acknowledgments

This study was funded by an administrative supplement to Grant NIH/NCRR1 UL1 RR024975-01 in part by CTSA award UL1TR000445. Additional support came from the National Alliance for Autism Research, a Vanderbilt University Interdisciplinary Discovery Grant and the Vanderbilt Kennedy Center for Research in Human Development. Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Health under Award Number NIH 2P01HL056693-19. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to André Diedrich.

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Harder, R., Malow, B.A., Goodpaster, R.L. et al. Heart rate variability during sleep in children with autism spectrum disorder. Clin Auton Res 26, 423–432 (2016). https://doi.org/10.1007/s10286-016-0375-5

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  • DOI: https://doi.org/10.1007/s10286-016-0375-5

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