Effects of mind-body exercise on body constitution and circadian rhythm in people with suboptimal health status.

BACKGROUND: Suboptimal health status (SHS) is a dynamic state in which people have not been diagnosed with a disease but tend to develop diseases. People with SHS are more prone to conditions such as cardiovascular disease and metabolic syndrome. Suitable interventions in people with SHS can prevent disease development. SHS is correlated with traditional Chinese medicine (TCM)-based constitutions, including Yang-Xu (yang deficiency), Yin-Xu (yin deficiency), and stasis types. The circadian rhythm is a potential biomarker of health and metabolism. Baduanjin exercise, a kind of mind-body exercise, has been regarded to adjust body constitution and metabolism, but few studies have evaluated the effects of Baduanjin exercise on body constitution and circadian rhythms. Therefore, this randomized controlled trial investigated the effects of Baduanjin exercise on body constitution and circadian rhythms in people with SHS. METHODS: Seventy-six participants with SHS were divided into the Baduanjin exercise and control groups (watching a Baduanjin video), with the interventions lasting 12 weeks. The Body Constitution Questionnaire (BCQ), SHS Questionnaire-25 (SHSQ-25), and actigraphy for circadian rhythm measurement were conducted. RESULTS: The scores of SHSQ-25, Yang-Xu, Yin-Xu, and BCQ stasis decreased significantly after 12 weeks in the Baduanjin exercise group, but not in the control group. Interdaily stability of the circadian rhythm increased significantly in the Baduanjin exercise group but not in the control group. CONCLUSION: This is the first report of improved health status, modulated body constitution, and increased interdaily stability of the circadian rhythm in participants with SHS who practiced Baduanjin exercise.

Disclosure of suboptimal health status through traditional Chinese medicine-based body constitution and pulse patterns.

OBJECTIVES: Suboptimal health status (SHS) is a dynamic state wherein people have not been diagnosed with a disease but tend to develop diseases. People with SHS often experience fatigue and other nonspecific symptoms, which are related to a deviated body constitution in traditional Chinese medicine (TCM). However, the correlation between TCM constitution and SHS has not been adequately investigated. Furthermore, no study has explored the radial pulse analysis-an assistive objective indicator of TCM constitution-in healthy people and people with SHS. DESIGN: A cross-sectional study. SETTINGS/LOCATION: Center for Traditional Medicine, Taipei Veterans General Hospital, Taiwan. SUBJECTS: Sixty-six adults (27 healthy participants and 39 participants with SHS) who were aged 20-39 years. OUTCOME MEASURES: The body constitution questionnaire (BCQ) scores, suboptimal health status questionnaire-25 (SHSQ-25) scores, and radial pulse waves detected using sphygmography were recorded. Pulse wave analyses are presented as the ratio of frequency below 10 Hz to that above 10 Hz (SER10), which represent energy changes in organ blood flow. RESULTS: Participants with SHS had significantly higher Yang-Xu, Yin-Xu, and stasis scores of BCQ compared with healthy participants. The SHSQ-25 scores of the participants with SHS were moderately correlated with their Yang-Xu, Yin-Xu, and stasis scores (r = 0.65, 0.66, and 0.72, respectively; all p < 0.001), but weak correlations were discovered for healthy participants. The participants with SHS had significantly higher SER10 at the left guan (the "liver" system in TCM) than did the healthy participants. CONCLUSIONS: SHS is moderately correlated with TCM-based constitution and those with SHS had increased SER10 at the leftguan of the radial pulse.

The application of yin-yang concept on heart rate variability patterns in menopausal women with insomnia.

OBJECTIVE: To develop heart rate variability (HRV) patterns for peri- and postmenopausal insomnia (PI) by the yin/yang concept of Chinese medicine (CM). METHODS: Seventy-four peri- and postmenopausal women (average age 56.6±1.0 years) with insomnia were enrolled in the study. HRV and the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) were recorded. The Autonomic Nervous System (ANS), Sympathetic and Parasympathetic Indices were derivative from the low frequency (LF), high frequency (HF) and ratio of LF to HF (LF/HF) components of the HRV. A deficiency or the excess pattern for PI was used for ANS index values > 0 or < 0, respectively. The deficiency pattern of PI was further divided into deficiency-yang (ANS index < 0, Sympathetic-Parasympathetic index > 0) and the deficiency-yin patterns (ANS index < 0, Sympathetic-Parasympathetic index < 0). The classification of the excess-yang and the excess-yin patterns of PI was carried out in the same way. The CPSQI and HRV parameters were compared to each of these patterns. RESULTS: The deficiency pattern (60.8 %) occurred more frequently than the excess pattern (39.2%) among PI participants. There were significantly longer bouts of insomnia, prolonged sleep latency, lower LF, HF, and LF/HF of HRV among individuals with the deficiency pattern than among those with the excess pattern among PI participants (P<0.05). The deficiency-yang pattern of PI participants had significantly prolonged sleep latency and decreased sleep efficiency, a higher LF/HF but a lower HF while compared to those with the deficiency-yin pattern (P<0.05). CONCLUSIONS: The results show a possible method of integration of biomedicine and CM by using physiological signals (HRV) combined with the concepts of CM (deficiency/excess and yin/yang) in order to develop diagnostic patterns of PI. This method may be applicable to the trials involving the use of acupuncture or Chinese herbs to treat PI.

The relationship of subjective sleep quality and cardiac autonomic nervous system in postmenopausal women with insomnia under auricular acupressure.

OBJECTIVE: The aim of this study is to examine the relationship between the changes in self-reported sleep symptoms and cardiac sympathovagal activity among women with postmenopausal insomnia (PI) who received auricular acupressure (AA) therapy. METHODS: A pretest/posttest study design was conducted at Taipei Veterans General Hospital, Taiwan, from August 2008 to July 2009. Forty-five women (mean ± SD age, 56.2 ± 5.4 years) with PI (4.9 ± 3.5 years of insomnia) received an AA therapy course on five auricular points every night before going to sleep for 4 weeks. Heart rate variability (HRV), the Chinese version of the Pittsburgh Sleep Quality Index, and the Menopause Rating Scale were measured before and after AA treatment. RESULTS: The total sleep duration and sleep efficiency were increased, and the sleep latency was shortened significantly (P < 0.01) after AA therapy. The total Menopause Rating Scale and somatovegetative subscale scores were reduced significantly (P < 0.05) after the intervention. A greater percentage change in Pittsburgh Sleep Quality Index was moderately correlated with both a lower percentage change in high-frequency power of HRV (r = -0.660, P < 0.001) and a greater percentage change in normalized low-frequency power (nLF) of HRV (r = 0.599, P < 0.001). An elevation of high-frequency power and a reduction of nLF of HRV were observed in the responder group, whereas a raise in nLF of HRV was noted in the nonresponder group. CONCLUSIONS: This study suggests that AA intervention leads to more cardiac parasympathetic and less cardiac sympathetic activity, which contributes to the improvement of PI.

Effects of ephedra on autonomic nervous modulation in healthy young adults.

AIM OF THE STUDY: Given the popularity of the use of ephedra in traditional Chinese medicine around the world, a greater understanding of its actions is required. This study aims to assess the effects of ephedra on autonomic nervous modulation using power spectral analysis of heart rate variability (HRV). METHODS: This was a randomized, double-blind, placebo-controlled, crossover study. Twenty healthy subjects were given 1g of ephedra dry extract or placebo once per day for 14 days in a crossover fashion with a 7-day washout period between treatments. Sequential HRV measures at baseline and at 30, 60, 120, and 180 min after taking ephedra or the placebo on days 1 and 14 were obtained and compared. In addition, the baseline HRV measurements on days 1, 3, 7, 10, and 14 were also obtained and compared. RESULTS: The normalized low-frequency component (LF%) and the low/high-frequency component ratio (LF/HF) of the HRV were significantly increased, whereas the high-frequency component (HF) and normalized HF (HF%) were significantly decreased at 120 and 180 min after taking ephedra on days 1 and 14. In addition, the baseline LF% and LF/HF were significantly increased, whereas the baseline HF% was significantly decreased on days 10 and 14, as compared to day 1. CONCLUSIONS: By power spectral analysis of the HRV of healthy young adults, it is suggested that ingestion of ephedra dry extract acutely and chronically affects autonomic nervous activity by tilting the sympathovagal balance toward increased sympathetic activity, whereas parasympathetic activity was impaired.

Sleep-related vagotonic effect of zolpidem in rats.

RATIONALE: Zolpidem is a relatively new nonbenzodiazepine sedative-hypnotic. The effects of zolpidem on autonomic functions remain unclear. OBJECTIVES: The aim of this study was to evaluate the effects of zolpidem on sleep and related cardiac autonomic modulations as compared with triazolam in Wistar-Kyoto rats. METHODS: Continuous power spectral analyses of electroencephalogram (EEG), electromyogram, and heart rate variability were performed on freely moving rats during daytime sleep. The consciousness states were classified into active waking (AW), quiet sleep (QS), and paradoxical sleep (PS). Drugs were administered via gavage and data within 2 h were analyzed. RESULTS: All zolpidem (ZP3, 3 mg/kg; ZP30, 30 mg/kg) and triazolam (TZ0.075, 0.075 mg/kg; TZ0.75, 0.75 mg/kg) groups had longer accumulated QS time and averaged QS duration as compared with the vehicle control. The accumulated QS time and averaged QS duration of ZP3 were similar to those of TZ0.075. Significant suppressions of PS time were noted in all drug groups except ZP3. During QS, ZP3 and ZP30 exhibited significant increases of magnitude and percentage of EEG delta power, whereas TZ0.075 and TZ0.75 did not. Heart period and high-frequency power of heart rate variability increased significantly in ZP3 during all sleep-wake states. Both parameters, however, did not increase but even decreased in ZP30, TZ0.075, and TZ0.75. CONCLUSIONS: Zolpidem not only caused a longer and deeper sleep but also led to an elevated cardiac vagal activity at a specific dose in the rat.

An alternative method to enhance vagal activities and suppress sympathetic activities in humans.

Vagal withdrawal and/or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body. We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans. Experiments were carried out on nine healthy male volunteers, while they were lying in a quiet room during 2-4 P.M. Acupuncture was applied 2 mm deep into the skin using standard stainless acupuncture needles at the Sishencong points, which are located on the vertex of the head, each 1 cm away from Baihui (GV 20) in four directions. Four points around the temporal area were selected as control points. Forty minutes of precordial ECG signals before, during, and after acupuncture were recorded continuously. Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance, high-frequency power (HF, 0.15-0.40 Hz) and low-frequency power (LF, 0.04-0.15 Hz) in normalized units (LF%). Acupuncture on the Sishencong points resulted in an increased HF but a decreased LF% compared with the before acupuncture stage. Such effects did not occur when manual acupuncture was applied to the control points. The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles. Based on these results, we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans. The underlying mechanisms and potential applications warrant further investigations.