Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery

ObjectiveHeart rate variability (HRV), which reflects the balance of the sympathetic and parasympathetic systems, is associated with insomnia. However, its relationship with preoperative acute insomnia has not yet been investigated. This study aimed to assess the associations of HRV characteristics...

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Main Authors: Zhenqiao Zhao, Junchao Liang, Shujie Hou, Guojia Zhu, Ning Liu, Wei Hao, Zhijuan Xu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1513395/full
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author Zhenqiao Zhao
Junchao Liang
Shujie Hou
Guojia Zhu
Ning Liu
Wei Hao
Zhijuan Xu
author_facet Zhenqiao Zhao
Junchao Liang
Shujie Hou
Guojia Zhu
Ning Liu
Wei Hao
Zhijuan Xu
author_sort Zhenqiao Zhao
collection DOAJ
description ObjectiveHeart rate variability (HRV), which reflects the balance of the sympathetic and parasympathetic systems, is associated with insomnia. However, its relationship with preoperative acute insomnia has not yet been investigated. This study aimed to assess the associations of HRV characteristics with preoperative acute insomnia.MethodsThis study enrolled 563 patients who were scheduled for elective surgery. Preoperative clinical characteristics, including demographics, the apnea–hypopnea index (AHI), HRV characteristics, and sleep quality data, were recorded.ResultsAmong the 563 patients included, 78.5% met the criteria for insomnia. Age (P = 0.005), AHI score (P < 0.001), and AHI stage (P < 0.001) were positively associated, whereas education level (P = 0.004) was negatively associated with preoperative acute insomnia. In terms of HRV characteristics, low-frequency (LF) (P = 0.012) and high-frequency (HF) (P = 0.011) were positively associated with preoperative acute insomnia. Multivariate logistic regression analyses screened out the variables associated with preoperative acute insomnia, including education level [P = 0.028, odds ratio (OR) = 0.603], AHI score (P < 0.001, OR = 1.068), standard deviation of all normal NN intervals (SDNN) (P = 0.004, OR = 0.956), the root mean square of the successive differences (rMSSD) (P= 0.001, OR = 1.130), NN50 count divided by the total number of all NN intervals (pNN50) (P = 0.006, OR = 0.893), ultra-low-frequency (ULF) (P = 0.003, OR = 1.000), LF/HF ratio (P = 0.018, OR = 0.608), and HF ratio (P = 0.072, OR = 0.953). Receiver operating characteristic analysis revealed that the combination of these variables had good predictive value for preoperative acute insomnia, with an area under the curve of 0.750.ConclusionPreoperative acute insomnia is a prevalent issue and is associated with an imbalance in the sympathetic/parasympathetic system. A predictive model based on HRV characteristics may improve the management of preoperative acute insomnia.
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spelling doaj-art-1ee44d3f8e8949378d8a3fbc50e686102025-08-20T03:48:57ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15133951513395Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgeryZhenqiao Zhao0Junchao Liang1Shujie Hou2Guojia Zhu3Ning Liu4Wei Hao5Zhijuan Xu6Graduate School of Hebei University of Traditional Chinese Medicine, Shijiazhuang, Hebei, ChinaDepartment of Anesthesiology, Hebei Provincial Hospital of Traditional Chinese Medicine, Hebei Technology Innovation Center of TCM Spleen and Kidney Diseases, Shijiazhuang, Hebei, ChinaGraduate School of Hebei University of Traditional Chinese Medicine, Shijiazhuang, Hebei, ChinaGraduate School of Hebei University of Traditional Chinese Medicine, Shijiazhuang, Hebei, ChinaOffice of Physician-Patient Communication, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei, ChinaDepartment of Anesthesiology, Hebei Provincial Hospital of Traditional Chinese Medicine, Hebei Technology Innovation Center of TCM Spleen and Kidney Diseases, Shijiazhuang, Hebei, ChinaDepartment of Hepatobiliary Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaObjectiveHeart rate variability (HRV), which reflects the balance of the sympathetic and parasympathetic systems, is associated with insomnia. However, its relationship with preoperative acute insomnia has not yet been investigated. This study aimed to assess the associations of HRV characteristics with preoperative acute insomnia.MethodsThis study enrolled 563 patients who were scheduled for elective surgery. Preoperative clinical characteristics, including demographics, the apnea–hypopnea index (AHI), HRV characteristics, and sleep quality data, were recorded.ResultsAmong the 563 patients included, 78.5% met the criteria for insomnia. Age (P = 0.005), AHI score (P < 0.001), and AHI stage (P < 0.001) were positively associated, whereas education level (P = 0.004) was negatively associated with preoperative acute insomnia. In terms of HRV characteristics, low-frequency (LF) (P = 0.012) and high-frequency (HF) (P = 0.011) were positively associated with preoperative acute insomnia. Multivariate logistic regression analyses screened out the variables associated with preoperative acute insomnia, including education level [P = 0.028, odds ratio (OR) = 0.603], AHI score (P < 0.001, OR = 1.068), standard deviation of all normal NN intervals (SDNN) (P = 0.004, OR = 0.956), the root mean square of the successive differences (rMSSD) (P= 0.001, OR = 1.130), NN50 count divided by the total number of all NN intervals (pNN50) (P = 0.006, OR = 0.893), ultra-low-frequency (ULF) (P = 0.003, OR = 1.000), LF/HF ratio (P = 0.018, OR = 0.608), and HF ratio (P = 0.072, OR = 0.953). Receiver operating characteristic analysis revealed that the combination of these variables had good predictive value for preoperative acute insomnia, with an area under the curve of 0.750.ConclusionPreoperative acute insomnia is a prevalent issue and is associated with an imbalance in the sympathetic/parasympathetic system. A predictive model based on HRV characteristics may improve the management of preoperative acute insomnia.https://www.frontiersin.org/articles/10.3389/fneur.2025.1513395/fullpreoperative acute insomniaheart rate variabilitypredictive modelreceiver operating characteristicnomogram
spellingShingle Zhenqiao Zhao
Junchao Liang
Shujie Hou
Guojia Zhu
Ning Liu
Wei Hao
Zhijuan Xu
Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
Frontiers in Neurology
preoperative acute insomnia
heart rate variability
predictive model
receiver operating characteristic
nomogram
title Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
title_full Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
title_fullStr Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
title_full_unstemmed Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
title_short Association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
title_sort association of heart rate variability with preoperative acute insomnia in patients scheduled for elective surgery
topic preoperative acute insomnia
heart rate variability
predictive model
receiver operating characteristic
nomogram
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1513395/full
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