The authors wish to thank Shan-Ing Chen and Chen-Ru Wang for their excellent technical assistance. This work was supported by the National Science Council of Taiwan (NSC 95-2314-B-075-111), Taipei Veterans General Hospital (V96C1-083, V97C1-132, V97F-005), the G. Harold and Leila Y. Mathers Foundation, the James S. McDonnell Foundation, the NIH-sponsored Research Resource for Complex Physiologic Signals (UO1EB008577), and DynaDx Corporation, Mountain View, California. The algorithm used in the analysis is based on the cardiopulmonary coupling software developed at the Beth Israel Deaconess Medical Center, Boston, MA by CKP, JEM, ALG, and RJT and licensed to Embla, Inc. CKP and JEM have financial interest in DynaDx Corp.
Sleep state instabilities in major depressive disorder: Detection and quantification with electrocardiogram-based cardiopulmonary coupling analysis
Article first published online: 6 JUL 2010
Copyright © 2010 Society for Psychophysiological Research
Volume 48, Issue 2, pages 285–291, February 2011
How to Cite
Yang, A. C., Yang, C.-H., Hong, C.-J., Tsai, S.-J., Kuo, C.-H., Peng, C.-K., Mietus, J. E., Goldberger, A. L. and Thomas, R. J. (2011), Sleep state instabilities in major depressive disorder: Detection and quantification with electrocardiogram-based cardiopulmonary coupling analysis. Psychophysiology, 48: 285–291. doi: 10.1111/j.1469-8986.2010.01060.x
- Issue published online: 6 JAN 2011
- Article first published online: 6 JUL 2010
- (Received August 7, 2009; Accepted March 29, 2010)
- Sleep stability;
- Cyclic alternating pattern;
- Cardiopulmonary coupling analysis;
- Electrocardiogram-derived sleep spectrogram
Sleep disruption is an important aspect of major depressive disorder but lacks an objective and inexpensive means of assessment. We evaluated the utility of electrocardiogram (ECG)-based cardiopulmonary coupling analysis to quantify physiologic sleep stability in patients with major depression. Relative to controls, unmedicated depressed patients had a reduction in high-frequency coupling, an index of stable sleep, an increase in low-frequency coupling, an index of unstable sleep, and an increase in very-low-frequency coupling, an index of wakefulness/REM sleep. The medicated depressed group showed a restoration of stable sleep to a level comparable with that of the control group. ECG-based cardiopulmonary coupling analysis may provide a simple, cost-efficient point-of-care method to quantify sleep quality/stability and to objectively evaluate the severity of insomnia in patients with major depression.