오전과 오후에 측정한 심박동수변이의 변화
The Changes in Heart Rate Variability between Morning and Afternoon
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초록
연구배경: 심박동수변이(heart rate variability)의 단기측정은 자율신경계를 평가하는 비침습적인 방법이다. 심박동수변이는 24시간 생체주기와 수면/활동 여부에 따라 하루주기를 보인다. 일차진료영역에서는 단기 심박동수변이 분석을 주로 낮 동안 이용하게 되므로 동일개체에서 오전과 오후에 측정한 심박동수변이에 차이가 있는지와 대상자의 불안이나 우울경향, 수면시간, 피로 정도에 따라 영향을 받는지 조사하고자 하였다. 방법: 20대의 건강한 성인 68명을 대상으로 오전 8시 30분∼11시와 익일 오후 1시 30분∼4시에 심박동수변이를 측정하였고, 설문을 통해 대상자의 우울, 불안, 피로, 수면시간, 건강상태, 생활습관 등을 조사하였다. 결과: 오전에 비해 오후에는 심박수가 유의하게 상승하였고, SDNN (standard deviation of normal to normal interval), RMSSD (root-mean-square of successive differences), TP (total power), HF (high frequency), VLF (very low frequency)가 유의하게 감소하였다. LF (low frequency), LF/HF는 유의한 변화를 보이지 않았다. 불안경향이 있는 군, 우울경향이 있는 군, 피로군은 정상군에 비해 TP와 RMSSD의 감소 정도가 유의하게 컸다. 결론: 동일한 개체에서 익일 시행된 심박동수변이의 단기 분석결과, 오전에 비해 오후에는 부교감신경과 총변이가 유의하게 감소하였으며 우울이나 피로를 호소하는 경우는 정상군에 비해 심박동수변이의 감소가 더 크게 나타났다. 이는 심박동수변이 단기측정시 일정한 시간대와 음식섭취 여부의 제한의 중요성을 시사한다.
Abstract
Background: Short-term measurement of heart rate variability is known to be a non-invasive technique to examine autonomic nerve system. Heart rate variability exhibits circadian rhythm according to work/sleep cycle and biological clock. In primary practice, short-term measurement of heart rate variability is usually used during the day. Therefore the aims of this study were to investigate the possibility of differences in heart rate variability between morning and afternoon and also to examine the relationship among associated factors. Methods: Sixty-eight healthy volunteers underwent short- term measurement of heart rate variability on two occasions: in the morning (08：30∼11：00) and in the afternoon (13：30∼16：00). A structured questionnaire was used to access general characteristics, emotion, fatigue and sleeping hours. Results: The mean heart rate was significantly increased and SDNN, RMSSD, TP, HF and VLF were significantly decreased in the afternoon compared to the morning. LF and LF/HF were not changed. The anxiety group, the depression group and the fatigue group showed significantly greater reduction in TP and RMDDS than the control group. Conclusion: In the afternoon, parasympathetic activity and total power were decreased significantly compared to the morning. Short-term heart rate variability should be measured in the same time zone and need to consider food intake effect. Those who complained of anxiety, depression or fatigue were related to much decrease in TP and RMSSD in the afternoon.
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