Associations between sleep-related heart rate variability and both sleep and symptoms of depression and anxiety: A systematic review

There is a bidirectional relationship between poor sleep and both mood-and anxiety-related disorders, which are among leading global health concerns. Additionally, both disordered sleep and these psy-chiatric disorders appear to be independently associated with altered autonomic nervous system (ANS) function. We hypothesise that ANS dysregulation during sleep may explain part of the relationship be-tween poor sleep and mood-and anxiety-related disorders. Heart rate variability (HRV) is a frequently used marker of ANS function and gives an indication of ANS input to the heart -in particular, of the relative contributions of sympathetic and parasympathetic activity. A systematic review of PubMed, Scopus and Web of Science yielded 41 studies dealing with sleep, mood-and anxiety-related disorders and sleep-related HRV. Hyperarousal during sleep, reflecting a predominance of sympathetic activation and indicative of ANS dysregulation, may be an important factor in the association between poor sleep and mood-related disorders. Longitudinal studies and mediation analyses are necessary to further un-derstand the potential mediating role of ANS dysregulation on the relationship between poor sleep and mood-and anxiety-related disorders. (c) 2022 Elsevier B.V. All rights reserved.

Automated summary

There is a bidirectional relationship between poor sleep and mood-and anxiety-related disorders, and both are independently associated with altered autonomic nervous system (ANS) function. Heart rate variability (HRV) can reflect ANS dysregulation during sleep, which may play a mediating role in the association between poor sleep and mood-and anxiety-related disorders.