Download The DPA and Heart Rate Variability and Post Traumatic Stress

THE DPA AND HEART RATE VARIABILITY
POST TRAUMATIC STRESS SYNDROME
Pentagon report released in June 2007 reported that U.S. troops
returning from combat in Iraq and Afghanistan suffered "daunting and
growing" psychological problems: 38% of Army soldiers, 31% of
Marines and 49% of National Guard members reported post-traumatic
stress disorder (PTSD) symptoms, depression, anxiety and other
potentially disabling mental disorders. Report of the Department of
Defense Task Force on Mental Health — June 2007
Although not all returning soldiers develop PTSD or other mental
disorders, most have significant issues returning to normal lives.
Everyone has different issues while reintegrating, but common
challenges include disassociation, anger, anxiety, sleeplessness,
depression, nightmares, inability to stop repeating thought loops and
continually replaying traumatic scenarios. Physiological responses
include nausea, diarrhea and chronic pain. Many turn to drugs and
alcohol to help them cope, which can lead to addiction or cause serious
disruption with family members and self-destructive behavior patterns.
“There is a major health crisis facing those men and women who have
served our nation in Iraq and Afghanistan,” said Terri Tanielian, the
project’s co-leader and a researcher at RAND, a nonprofit research
organization. “Unless they receive appropriate and effective care for
these mental health conditions, there will be long-term consequences
for them and for the nation. Unfortunately, we found there are many
barriers preventing them from getting the high-quality treatment they
need.”
Researchers also found an urgent need to train more mental health
providers throughout the U.S. health care system on delivering
evidence-based treatments to service members and veterans. While
many opportunities for treatment exist for active-duty personnel, there
is no system in place to monitor the quality of those services to ensure
they are getting the latest science-based forms of treatment.
Heart Rate Variability (HRV) has been shown to be a reliable noninvasive test for quantitative assessment of the cardiovascular
autonomic regulatory responses, providing a window reflecting the
interaction of sympathetic and parasympathetic tone. Alterations in
autonomic function are associated with a variety of physiologic and
pathophysiologic processes and may contribute substantially to
morbidity and mortality.
Studies have shown that patients with post-traumatic stress disorder
have significantly lower HRV compared to controls, reflecting a basal
autonomic state characterized by increased sympathetic and
decreased parasympathetic tone. Changes in heart rate variability
associated with acute stress may represent one pathway to disturbed
sleep. Stress-related changes in heart rate variability during sleep may
also be important in association with chronic stressors, which are
associated with significant morbidity and increased risk for mortality.
Heart rate varies around a mean value, depending upon inputs from
the sympathetic and parasympathetic nervous system, and this
variation is referred to as heart rate variability. Cohen et al. found
that patients with PTSD at rest and higher heart rates, lower HRV with
lower high frequency (HF reflects the vagal activity – slows down heart
rate) and higher low frequency (LF affected by both sympathetic and
parasympathetic), compared to controls, pointing towards a reduced
resting parasympathetic tone (brake) and increased sympathetic (fight
and flight).
Based on this, they suggested that PTSD is a state of chronic
autonomic hyperstimulation, which prevents the autonomic system
from responding to further stimuli. Low HRV is associated with
adverse behaviors such as smoking, alcohol, poor diet and decreased
exercise, and shows a strong linear association with various
components of the metabolic syndrome, such as increased systolic
blood pressure, HDL cholesterol, triglycerides, waist circumference,
and fasting and two-hour postload glucose levels which are all
associated with increased coronary risk factors.
The Digital Pulse Analyzer (DPA) provides a quick 5 minute, noninvasive assessment of HRV and can monitor efficacy of treatment
modalities, as presently no system in place to monitor the quality of
those services to ensure they are getting the latest science-based
forms of treatment.