Kalp Hızı Değişkenliği, Müteakip Gece Uyku Parametreleri ve Kortizol Uyanma Yanıtı ile İlişkili Değildi

Amaç: Uyku bozukluğu ve uyku düzeninin değişmesi hipotalamus-hipofiz-adrenal aksı (HPA) ve otonom sinir sistemini (OSS) etkilediği bildirilmiştir. Ancak gün içerisindeki otonom sinir sistemi aktivitesinin gece uykusuna ve bir sonraki gün HPA aksına etkisi bilinmemektedir. Bu nedenle, mevcut çalışmanın amacı, OSS aktivitesinin belirteci olan kalp hızı değişkenliğinin (KHD), gece uyku parametreleri ve bir sonraki gün HPA aksının belirteci olan kortizol uyanma yanıtına (KUY) olan etkisini incelemekti.Materyal ve Metod: Bu çalışmada 48 sağlıklı Tıp Fakültesi öğrencilerinden KHD belirlemek için 5 dakikalık elektrokardiyografi (EKG) kaydı alındı. Takip eden gece normal uyku düzenlerinde uyumaları sağlandı. Uyku verilerini elde etmek için uyku ölçekleri dolduruldu (Karolinska uyku günlüğü ve ölçeği). KUY ölçümü için sabah uyandıktan 0, 15, 30 ve 60 dakika sonra tükürük örnekleri toplandı. Tükürük örneklerinde kortizol konsantrasyonu enzim immunoassay yöntemiyle belirlendi. Korelasyonlar Spearman Rho ile bakıldı. P < 0.05 değerleri anlamlı kabul.edildi.Bulgular: Katılımcıların çoğunda (%80) zaman bağımlı değişimlerin normal sınırlar içerisindeydi ve bu kişiler uyku bozukluğu yaşamamışlardı. Gün içerisinde elde edilen KHD’nin zaman ve frekans bağımlı parametrelerinin, takip eden gün içerisindeki uyku parametreleri (uyanma ve uyku süresi, uyku bozukluğu, uyanma problemleri) ve KUY (ortalama, eğri altında kalan alan) ile bir korelasyon bulunmadı (p>0.05).Sonuç: Bu çalışmanın sonuçları gösteriyor ki; OSS aktivitesi üzerinde derin etkileri olmayan koşullar altında ne uyku parametrelerinin ne de ertesi sabah kortizol yanıtlarının KHD'den etkilenmediğini göstermektedir. Buna ek olarak, kaliteli bir gece uykusu hem önceki günlerin otonom baskılarının olası etkilerini hem de ertesi sabahın kortizol tepkilerini dengeleyebilir.

Anahtar Kelimeler:

Uyku, Kortizol, Kalp hızı değişkenliği (KHD)

Heart Rate Variability was not Associated with Subsequent Night Sleep Parameters and Cortisol Awakening Response

Background: Changes in sleep duration and sleep disturbance have been reported to affect hypothalamic-pituitary-adrenal axis (HPA) and the autonomic nervous system (ANS) activities. However, the effect of ANS activity on sleep parameters and HPA activity in the subsequent night and morning is not known. The aim of the current study, was, therefore, to assess the effects of heart rate varibility (HRV) on subsequent night sleep parameters and cortisol awakening response (CAR). Materials and Methods: Electrocardiographic recordings were carried out for 5 min for determination of HRV in healty medical students (n=48). They were allowed to sleep in their normal routines in following night. Sleep diaries were filled for sleep parameters (Karolinska Sleep Diary and Questionnaire). Salivary samples were taken at 0, 15, 30- and 60-min post-awakening for measurement of CAR. Cortisol concentrations were measured in the salivary samples by enzyme immunoassay. Correlations were carried out by Spearman Rho. p <0.05 values were considered significant.Results: The majority of the participants (80%) had time-domain variables within the normal range and they did not have sleep disturbances. Time- and frequency-domain parameters of HRV during the morning did not correlate with sleep parameters (time, duration, disturbed sleep, awakening problems) or CAR (mean, area under the curve) in the next day (p>0.05).Conclusion: The results of the current study suggest that, under the conditions which do not have profound effects on ANS activity, neither sleep parameters nor the next morning cortisol responses are affected by HRV. Additionally, a quality night sleep might counterbalance both the possible effects of previous days autonomic pressures and the next morning’s cortisol responses.

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