Evaluation of Autonomic Nervous System Function During Sleep by Mindful Breathing Using a Tablet Device: Randomized Controlled Trial

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Abstract

Background

One issue to be considered in universities is the need for interventions to improve sleep quality and educational systems for university students. However, sleep problems remain unresolved. As a clinical practice technique, a mindfulness-based stress reduction method can help students develop mindfulness skills to cope with stress, self-healing skills, and sleep.

Objective

We aim to verify the effectiveness of mindful breathing exercises using a tablet device.

Methods

In total, 18 nursing students, aged 18-22 years, were randomly assigned and divided equally into mindfulness (Mi) and nonmindfulness (nMi) implementation groups using tablet devices. During the 9-day experimental period, cardiac potentials were measured on days 1, 5, and 9. In each sleep stage (sleep with sympathetic nerve dominance, shallow sleep with parasympathetic nerve dominance, and deep sleep with parasympathetic nerve dominance), low frequency (LF) value, high frequency (HF) value, and LF/HF ratios obtained from the cardiac potentials were evaluated.

Results

On day 5, a significant correlation was observed between sleep duration and each sleep stage in both groups. In comparison to each experimental day, the LF and LF/HF ratios of the Mi group were significantly higher on day 1 than on days 5 and 10. LF and HF values in the nMi group were significantly higher on day 1 than on day 5.

Conclusions

The correlation between sleep duration and each sleep stage on day 5 suggested that sleep homeostasis in both groups was activated on day 5, resulting in similar changes in sleep stages. During the experimental period, the cardiac potentials in the nMi group showed a wide range of fluctuations, whereas the LF values and LF/HF ratio in the Mi group showed a decreasing trend over time. This finding suggests that implementing mindful breathing exercises using a tablet device may suppress sympathetic activity during sleep.

Trial Registration

UMIN-CTR Clinical Trials Registry UMIN000054639; https://tinyurl.com/mu2vdrks

Related collections

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Experimental sleep restriction causes impaired glucose tolerance (IGT); however, little is known about the metabolic effects of habitual sleep restriction. We assessed the cross-sectional relation of usual sleep time to diabetes mellitus (DM) and IGT among participants in the Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing. Participants were 722 men and 764 women, aged 53 to 93 years. Usual sleep time was obtained by standardized questionnaire. Diabetes mellitus was defined as a serum glucose level of 126 mg/dL or more (> or =7.0 mmol/L) fasting or 200 mg/dL or more (> or =11.1 mmol/L) 2 hours following standard oral glucose challenge or medication use for DM. Impaired glucose tolerance was defined as a 2-hour postchallenge glucose level of 140 mg/dL or more (> or =7.8 mmol/L) and less than 200 mg/dL. The relation of sleep time to DM and IGT was examined using categorical logistic regression with adjustment for age, sex, race, body habitus, and apnea-hypopnea index. The median sleep time was 7 hours per night, with 27.1% of subjects sleeping 6 hours or less per night. Compared with those sleeping 7 to 8 hours per night, subjects sleeping 5 hours or less and 6 hours per night had adjusted odds ratios for DM of 2.51 (95% confidence interval, 1.57-4.02) and 1.66 (95% confidence interval, 1.15-2.39), respectively. Adjusted odds ratios for IGT were 1.33 (95% confidence interval, 0.83-2.15) and 1.58 (95% confidence interval, 1.15-2.18), respectively. Subjects sleeping 9 hours or more per night also had increased odds ratios for DM and IGT. These associations persisted when subjects with insomnia symptoms were excluded. A sleep duration of 6 hours or less or 9 hours or more is associated with increased prevalence of DM and IGT. Because this effect was present in subjects without insomnia, voluntary sleep restriction may contribute to the large public health burden of DM.

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Author and article information

Contributors

Eiichi Togo:

ORCID: https://orcid.org/0009-0000-2546-0992

Department of Nursing, Faculty of Nursing, Hyogo University2301Hiraoka-cho ShinzaikeKakogawa City, 675-0195Japan81 794279516tougo@hyogo-dai.ac.jp

Journal

Journal ID (nlm-ta): JMIR Nurs

Journal ID (iso-abbrev): JMIR Nurs

Journal ID (publisher-id): JN

Title: JMIR Nursing

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2562-7600

Publication date Collection: 2024

Publication date (Electronic): 12 June 2024

Volume: 7

Electronic Location Identifier: e56616

Affiliations

[1 ] Department of Nursing, Faculty of Nursing, Hyogo University Kakogawa City Japan

[2 ] College of Nursing Art and Science, University of Hyogo Akasi City Japan

Author notes

Corresponding Author: Eiichi Togo tougo@ 123456hyogo-dai.ac.jp

Author information

Eiichi Togo https://orcid.org/0009-0000-2546-0992

Miki Takami https://orcid.org/0009-0005-5728-1098

Kyoko Ishigaki https://orcid.org/0009-0007-3531-771X

Article

Publisher ID: v7i1e56616

DOI: 10.2196/56616

PMC ID: 11208833

PubMed ID: 38865177

SO-VID: 99cc3392-560e-4c5e-a8b4-7e4a7461121c

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Nursing, is properly cited. The complete bibliographic information, a link to the original publication on https://nursing.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 22 January 2024

Date revision requested : 3 April 2024

Date revision received : 28 April 2024

Date accepted : 8 May 2024

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