Comparison of two different approaches in the detection of intermittent cardiorespiratory coordination during night sleep

BACKGROUND: The objective was to evaluate and to compare two completely different detection algorithms of intermittent (short-term) cardiorespiratory coordination during night sleep. The first method is based on a combination of respiratory flow and electrocardiogram recordings and determines the relative phases of R waves between successive onsets of inspiration. Intermittent phase coordination is defined as phase recurrence with accuracy α over at least k heartbeats. The second, recently introduced method utilizes only binary coded variations of heart rate (acceleration = 1, deceleration = 0) and identifies binary pattern classes which can be assigned to respiratory sinus arrhythmia (RSA). It is hypothesized that RSA pattern class recurrence over at least k heartbeats is strongly related with the intermittent phase coordination defined above. RESULTS: Both methods were applied to night time recordings of 20 healthy subjects. In subjects <45 yrs and setting k = 3 and α = 0.03, the phase and RSA pattern recurrence were highly correlated. Furthermore, in most subjects the pattern predominance (PP) showed a pronounced oscillation which is most likely linked with the dynamics of sleep stages. However, the analysis of bivariate variation and the use of surrogate data suggest that short-term phase coordination mainly resulted from central adjustment of heart rate and respiratory rate rather than from real phase synchronization due to physiological interaction. CONCLUSION: Binary pattern analysis provides essential information on short-term phase recurrence and reflects nighttime sleep architecture, but is only weakly linked with true phase synchronization which is rare in physiological processes of man.