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作者单位:Prof. Dr. Thomas Penzel (1) C. Garcia (1) M. Glos (1) M. Renelt (1) C. Sch枚bel (1) J. W. Kantelhardt (2) R. P. Bartsch (3) A. M眉ller (4) M. Riedl (4) N. Wessel (4) I. Fietze (1)
The recording of ECG and heart rate are indispensable parameters of cardiorespiratory polysomnography. Complementing neurophysiological signals this allows an assessment of the autonomous nervous regulation during sleep. An evaluation of the nocturnal ECG is possible in terms of cyclical variations of heart rate and in terms of respiration modulated changes of ECG morphology (amplitude of R wave and T wave). This provides a reliable estimation of sleep disordered breathing. The autonomous nervous system is regulated in a totally different way during slow wave sleep and during REM sleep. An assessment of beat-to-beat variability of heart rate allows deriving sleep stages based on the difference in autonomous nervous system regulation. In addition the transitions from wakefulness to sleep can be tracked to some degree by an analysis of heart rate variability. This paper presents the technical development of the analysis in a historical sequence from 1980 to 2015. Linked to this the increase in physiological and pathophysiological knowledge derived from the technical developments is presented. Keywords Sleep stages Autonomous function Heart rate Cardiovascular regulation Sleep apnea