Polygraphic Studies of Normal Infants during the First Six Months of Life. I. Heart Rate and Variability as a Function of State

Abstract

Extract: This study examined spontaneous heart rate (HR) and variability as a function of age and sleep state in eight normal full term infants from birth to 6 months of age. Heart rates recorded during sleep were lower and less regular at 1 week (quiet sleep (QS) mean rate = 128, interquartile range = 6.4 beats/min; rapid eye movement (REM) = 134.5, 11.6) than at 1 month (QS = 138.6, 3.4; REM 139.6, 4.2). Rate decreased sharply from 1 to 3 months (QS = 118; REM 123.8) and decreased only slightly thereafter (6-month QS = 113.5; REM 118.9). Variability decreased rapidly in REM from 2 to 4 months (from 11.4 to 9.1) and less quickly from 4 to 6 months (from 9.1 to 8.2), while QS variability decreased at 1 month (from 6.4 to 5.7) and became stable from that point (6.0 at 6 months). Waking heart rate and variability were both relatively low at 1 week (163, 11.2 beats/min) and increased from that age to 1 month (167.4, 14.3). Rate decreased rapidly in waking at 3 months (152 beats/min) and more slowly thereafter (152 beats/min at 4 months, 149 beats/min at 6 months), whereas variability remained elevated until after 3 months, becoming stable at a lower level during later infancy (3 months = 14.8, 6 months 11.7). Lowest values of rate and variability were found in QS and the highest values were found in waking at all ages, except at 1 week. Heart rates during REM closely approximated those in QS, whereas variability values more closely resembled those of waking. Speculation: It would appear that, in the normal infant, there are at least three relatively discrete stages in the ontogenetic sequence of cardiac rate and variability characteristics: a newborn period, early infancy (1–3 months), and later infancy. Since regulation of cardiac activity is greatly modified by sleep and waking behavior, the measurement of heart rate and variability must consider state as a factor in such regulation. Moreover, since states undergo both qualitative and quantitative changes during the first 6 months of age, the nature of cardiac regulation during this period may be a function of state maturation.