Effects of anxiety, depression and sleep disorders on heart rate variability in the elderly
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 5
Abstract
Objective To analyze the changes of autonomic nervous function mainly in heart rate variability (HRV) in elderly patients with anxiety, depression and sleep disorders, and explore the clinical significance of HRV indexes. Methods The inpatients who were evaluated in Department of Geriatrics, Xijing Hospital, Air Force Medical University from July 2021 to July 2022 were collected and divided into group A ( anxiety and depression group, n = 60), group B (sleep disorders group, n = 62), group C ( anxiety and depression combined with sleep disorders group, n = 54) and group D (no anxiety, depression or sleep disorders group, n = 49) according to whether they had anxiety, depression or sleep disorders. The HRV indexes of all subjects were compared and analyzed, including all standard deviation of normal to normal RR intervals (SDNN), standard deviation of the averages of 5-minute RR intervals (SDANN), root mean square of successive RR interval differences ( rMSSD), percentage of successive RR intervals that differ by more than 50 ms (PNN50), low frequency (LF), high frequency (HF), and LF / HF ratio (LF / HF). Results There were no significant differences in age, gender, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipid, blood pressure and LF / HF among the four groups, but there were significant differences in SDNN, SDANN, rMSSD, PNN50, LF and HF among the four groups (P < 0. 01). SDNN, SDANN, rMSSD, PNN50, LF and HF in group A, B and C were lower than those in group D (P < 0. 01). SDNN, SDANN, rMSSD, PNN50, LF and HF in group C were lower than those in group A and B (P < 0. 01) . There were significant differences in Hamilton Anxiety Scale ( HAMA), Hamilton Depression Scale ( HAMD) and Pittsburgh Sleep Quality Index (PSQI) scores among the four groups (P < 0. 01). HAMA, HAMD and PSQI scores in group A, B and C were higher than those in group D (P < 0. 01), and HAMA, HAMD and PSQI scores in group C were higher than those in group A and B (P < 0. 01). Multivariate logistic regression analysis showed that the decrease of SDNN, PNN50 and LF was an independent risk factor for anxiety and depression (P < 0. 05). Decreased PNN50 and LF were independent risk factors for sleep disorders (P < 0. 05). Conclusion The main mechanism for the reduction of HRV caused by anxiety, depression and sleep disorders is the autonomic nervous system dysfunction, in which PNN50 and LF are the common risk factors of anxiety, depression and sleep disorders, and good representatives in the measurement of emotional state and sleep quality. They can be used for quantitative evaluation of autonomic nervous function, which can be paid more attention in clinical diagnosis and treatment.
Authors and Affiliations
LIU Wenna, LI Rong, WANG Xiaoming, LI Chen, HUANG Zichen, WANG Shutong
Keywords
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