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Effects of prolonged and repeated immersions on heart rate variability and complexity in military divers

Background: The influence of prolonged and repeated water immersions on heart rate variability (HRV) and complexity was examined in 10 U.S. Navy divers who completed six-hour resting dives on five consecutive days. Pre-dive and during-dive measures were recorded daily. 

Methods: Dependent variables of interest were average heart rate (HR), time-domain measures of HRV [root mean square of successive differences of the normal RR (NN) interval (RMSSD), standard deviation of the NN interval (SDNN)], frequency-domain measures of HRV [low-frequency power spectral density (psd) (LFpsd), low-frequency normalized (LFnu), high-frequency psd (HFpsd), high-frequency normalized (HFnu), low-frequency/high-frequency ratio (LF/HF)], and non-linear dynamics of HRV  [approximate entropy (ApEn)]. A repeated-measures ANOVA was performed to examine pre-dive measure differences among baseline measures. Hierarchical linear modeling (HLM) was performed to test the effects of prolonged and repeated water immersion on the dependent variables. 

Results: Pre-dive HR (P=0.005) and RMSSD (P<0.001) varied significantly with dive day while changes in SDNN approached significance (P=0.055). HLM indicated that HR decreased during daily dives (P=0.001), but increased across dive days (P=0.011); RMSSD increased during daily dives (P=0.018) but decreased across dive days (P<0.001); SDNN increased during daily dives (P<0.001); LF measures increased across dive days (LFpsd P<0.001; LFnu P<0.001), while HF measures decreased across dive days (HFpsd P<0.001; HFnu P<0.001); LF/HF increased across dive days (P<0.001); ApEn decreased during daily dives (P<0.02) and across dive days (p<0.001). 

Conclusion: These data suggest that the cumulative effect of repeated dives across five days results in decreased vagal tone and a less responsive cardiovascular system.

DOI:10.22462/11.12.2017.10