Cardiology in the Young

Original Article

Normal ranges for the variability in heart rate in young infants while sleeping

Martial M. Massin a1c1, Nadia Withofs a1, Kristel Maeyns a1, Françoise Ravet a2 and Paul Gérard a3
a1 Division of Paediatric Cardiology, CHR Citadelle, University of Liège, Belgium
a2 Paediatric Sleep Unit, CHR Citadelle, University of Liège, Belgium
a3 Mathematical Institute, CHR Citadelle, University of Liège, Belgium

Article author query
massin mm   [PubMed][Google Scholar] 
withofs n   [PubMed][Google Scholar] 
maeyns k   [PubMed][Google Scholar] 
ravet f   [PubMed][Google Scholar] 
gérard p   [PubMed][Google Scholar] 


Objective: Measurements of the variability in heart rate are increasingly used as markers of cardiac autonomic activity. We sought to establish the development this variability in healthy young infants while sleeping. Patients: We carried out polygraphic studies with electrocardiographic recording in 587 healthy infants aged from 5 to 26 weeks. Methods: We determined several variables over a period of 400 minutes sleeping: mean RR interval, 5 time-domain (SDNN, SDNNi, SDANNi, RMSSD, and pNN50) and 5 frequency-domain indexes (spectral power over 3 regions of interest, total power and low-to-high frequency ratio). Frequency-domain indexes were also assessed separately for the periods of quiet sleep and those of rapid eye movement sleep. Results: Our data showed a significant correlation between the indexes of heart rate variability and the mean RR interval, the breathing rate, and the corrected age of the infants. We also demonstrated the importance of the maturation of the sleeping patterns. Conclusion: These data in a large cohort of healthy infants confirm a progressive maturation of the autonomic nervous system during sleep, and may be used to examine the influence of physiological and pathophysiological factors on autonomic control during polygraphic studies.

(Published Online August 15 2006)
(Accepted May 1 2001)

Key Words: Cardiac rate; infants; normal ranges; sleep; physiology.

c1 Correspondence to: Dr Martial Massin, MD, Division of Paediatric Cardiology, CHR Citadelle (University of Liège), Boulevard du 12è de Ligne, 1, B-4000 Liège, Belgium. Tel: +32 42257312; Fax: +32 42264747; E-mail: