Analysis of beat-to-beat heart rate changes during sleep-waking states in normal infants

Summary measures of heart rate variation describe those aspects of heart rate change that can be averaged over relatively long periods of time. We examined the postnatal maturation of a dynamic feature of cardiac rate--the dependency of each beat-to-beat change in cardiac interbeat interval on the previous beat-to-beat change. In each sleep-waking state, the number of delta RR (the difference between two successive R-R intervals) 4msec was determined as a percent of the total number of intervals (delta RR > 4ms/total delta RR), and each pair of successive interval differences was categorized based on the directions of the two changes (whether they reflected increases or decreases in cardiac intervals). Analysis of variance was used to identify alterations in the proportion of interval differences exceeding the minimum over ages and sleep-waking states, and to describe developments in the temporal patterns of cardiac interval changes. At all ages, infants showed fewer beat-to-beat interval changes during waking than during either sleep state. In all states, older infants showed significantly more beat-to-beat cardiac interval changes and a higher proportion of sustained changes (intervals increasing or decreasing consistently over several beats) than did young infants. Furthermore, infants 2 months and younger showed significantly more sustained increases than decreases in interbeat intervals, indicating gradual declines in heart rate and rapid increases, while older infants showed the opposite pattern.(ABSTRACT TRUNCATED AT 250 WORDS)