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Heart rate variability and insomnia in depressed patients with breast cancer
  1. Qianqian Zhang1,
  2. Sheng Yu2,
  3. Lingxue Tang2,
  4. Wen Li2,
  5. Senbang Yao2,
  6. Jiaying Chai2,
  7. Anlong Li2,
  8. Yingxue Jia2,
  9. Runze Huang2 and
  10. Huaidong Cheng2,3
  1. 1Second Affiliated Hospital of Anhui Medical University, Hefei, China
  2. 2Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
  3. 3Southern Medical University, Guangzhou, China
  1. Correspondence to Professor Huaidong Cheng; chd1975ay{at}126.com

Abstract

Objectives Depression is associated with unhealthy autonomic regulation. However, whether patients with breast cancer (BC) with different degrees of depression can be identified from linear and non-linear dynamics in the autonomic nervous system is unclear. We aimed to evaluate the differences in linear and non-linear heart rate variability (HRV) parameters in patients with BC with different degrees of depression and the relationship between HRV parameters and depression and sleep disorders.

Methods A total of 115 patients with BC were enrolled. According to their Self-Rating Depression Scale (SDS) scores, the patients were divided into a non-depressed group, a mildly depressed group and a moderately to severely depressed group. The Pittsburgh Sleep Quality Index (PSQI), HRV, linear index (including time and frequency domains) and non-linear index (including Poincare plot, approximate entropy (ApEn) and short-term fluctuation slope (DFAα1)) were evaluated.

Results Compared with patients without depssion, patients with mild depression and moderate-to-severe depression had significant differences in the time domain, frequency domain index, the SD perpendicular to the line-of-identity (SD1) and DFAα1 of non-linear HRV and sleep quality. SDS and PSQI scores were correlated with HRV parameters.

Conclusions The severity of depression in patients with BC is associated with reduced variability, complexity of cardiac dynamics and sleep disturbance.

  • Breast
  • Hospital care
  • Spiritual care
  • Depression
  • Symptoms and symptom management
  • Psychological care

Data availability statement

No data are available. All data required to evaluate the paper conclusions are presented in the paper and/or attached file.

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Data availability statement

No data are available. All data required to evaluate the paper conclusions are presented in the paper and/or attached file.

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Footnotes

  • QZ, SY and LT contributed equally.

  • Contributors HC, QZ and SY carried out the planning and decision-making for this research topic. LT, WL and SY collected baseline data and psychological scales. JC and YJ measured ECG. AL and RH analysed data analysis and made tables and graphs. HC, QZ and SY wrote and proofread the manuscript. All authors have read and approved the final draft. HC is the guarantor.

  • Funding This study was supported by the National Natural Science Foundation of China (No. 81872504).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.