Circadian Contrasts in Heart Rate Variability Associated With Posttraumatic Stress Disorder Symptoms in a Young Adult Cohort

Abstract

Prior research has demonstrated that individuals exposed to trauma are subject to impaired autonomic function. We sought to determine if heart rate variability (HRV), a marker of autonomic function, differed across wake, rest, and sleep periods as a function of posttraumatic stress disorder (PTSD) symptom severity. A sample of young adults (N = 209), 95 of whom met full criteria for current PTSD based upon the Clinician Administered PTSD Scale (CAPS), were evaluated for approximately 24-hours using actigraphy and electrocardiogram. Actigraphy findings were categorized as active, rest, and sleep. In multilevel modeling, individuals with high PTSD symptom severity exhibited lower high-frequency HRV than individuals with low PTSD symptom severity during periods of sleep, t(1083) = 2.20, p = .028, Cohen’s d = 0.12, but not during periods of activity, t(1083) = 1.34, p = .499, d = 0.05, or rest, t(1083) = 1.34, p = .180, d = 0.09. Our findings extended those of prior studies to suggest that, those with elevated PTSD symptoms may not only have decreased parasympathetic control during sleep, but relative to periods of wake and rest, sleep may represent a state increased vulnerability for decreased parasympathetic cardiac control. Individuals with elevated PTSD symptoms may require screening for early detection of cardiovascular disease.

Posttraumatic stress disorder diagnosis is associated with reduced parasympathetic activity during sleep in US veterans and military service members of the Iraq and Afghanistan wars

“…As such, it's not clear if or how military versus civilian status might be relevant to differing findings across studies. Our findings also parallel those of a prior study [41] examining HF-HRV as a function of PTSD severity in a sample of young adults (N = 209; 95 with current PTSD) across actigraphically-assessed wake, rest, and sleep. Those with higher PTSD symptom severity had lower HF-HRV than those with lower PTSD symptom severity, but only during periods of sleep.…”

e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD)

“…Several studies (Green et al, 2016; Moon, Lee, Kim, & Hwang, 2013; Norte et al, 2013; Rissling et al, 2016; Wahbeh & Oken, 2013) found a decrease in HRV in patients with PTSD, pointing out that PTSD symptoms may be related to decreased parasympathetic control, especially during sleep (which could constitute a state of vulnerability for decreased parasympathetic cardiac control) (Kobayashi, Lavela, & Mellman, 2014). Other studies demonstrated that low HRV as a sign of over-reactivity to stress were present prior to the development of PTSD (Eraly et al, 2014; Minassian et al, 2015).…”

Frontal Alpha Asymmetry, Heart Rate Variability, and Positive Resources in Bereaved Family Members with Suicidal Ideation after the Sewol Ferry Disaster

“…The HRV was examined for 5 min during the morning (9 a.m. to noon) to prevent the influence of the circadian rhythm [16]. Electrodes were attached to the participant’s right and left wrists in a calm environment [17,18].…”