{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:11:58Z","timestamp":1778299918084,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Undersea Vehicle Technology (NIUVT)","award":["COMP-22"],"award-info":[{"award-number":["COMP-22"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The relationship between sleep dynamics and blood pressure (BP) changes is well established. Moreover, sleep efficiency and wakefulness during sleep (WASO) events have a significant impact on BP dipping. Despite this knowledge, there is limited research on the measurement of sleep dynamics and continuous blood pressure (CBP). This study aims to explore the relationship between sleep efficiency and cardiovascular function indicators such as pulse transit time (PTT), as a biomarker of CBP, and heart rate variability (HRV), measured using wearable sensors. The results of the study conducted on 20 participants at the UConn Health Sleep Disorders Center suggest a strong linear relationship between sleep efficiency and changes in PTT (r2 = 0.8515) and HRV during sleep (r2 = 5886). The findings of this study contribute to our understanding of the relationship between sleep dynamics, CBP, and cardiovascular health.<\/jats:p>","DOI":"10.3390\/s23115112","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:18:43Z","timestamp":1685204323000},"page":"5112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Exploring the Potential of Pulse Transit Time as a Biomarker for Sleep Efficiency through a Comparison Analysis with Heart Rate and Heart Rate Variability"],"prefix":"10.3390","volume":"23","author":[{"given":"Jenna","family":"Bridges","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA"},{"name":"Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA"}]},{"given":"Hossein Hamidi","family":"Shishavan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA"},{"name":"Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA"}]},{"given":"Adrian","family":"Salmon","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA"}]},{"given":"Mark","family":"Metersky","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6539-1776","authenticated-orcid":false,"given":"Insoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA"},{"name":"Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jsmc.2016.10.012","article-title":"HHS Public Access: Sleep. Health, and Society","volume":"12","author":"Grandner","year":"2017","journal-title":"Sleep Med. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.sleh.2021.06.003","article-title":"Sleep quality and duration are associated with greater trait emotional intelligence","volume":"8","author":"Killgore","year":"2022","journal-title":"Sleep Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.ogc.2015.05.013","article-title":"Sleep deprivation","volume":"42","author":"Abrams","year":"2015","journal-title":"Obstet. Gynecol. Clin."},{"key":"ref_4","unstructured":"Altevogt, B.M., and Colten, H.R. (2016). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem, National Academies Press."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1080\/01616412.2017.1315864","article-title":"A review of sleep disorders and melatonin","volume":"39","author":"Xie","year":"2017","journal-title":"Neurol. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/S0031-9384(97)00234-5","article-title":"Vegetative background of sleep: Spectral analysis of the heart rate variability","volume":"62","author":"Scholz","year":"1997","journal-title":"Physiol. Behav."},{"key":"ref_7","unstructured":"Clifford, G. (2002). Signal Processing Methods for Heart Rate Variability. [Doctoral Dissertation, Oxford University]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3389\/fphys.2012.00045","article-title":"Modulation of the sympatho-vagal balance during sleep: Frequency domain study of heart rate variability and respiration","volume":"3","author":"Cabiddu","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jsmc.2017.02.003","article-title":"Sleep architecture and blood pressure","volume":"12","author":"Jafari","year":"2017","journal-title":"Sleep Med. Clin."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An overview of heart rate variability metrics and norms","volume":"5","author":"Shaffer","year":"2017","journal-title":"Front. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Electrophysiology, Task Force of the European Society of Cardiology the North American Society of Pacing (1996). Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Circulation, 93, 1043\u20131065.","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chalmers, T., Hickey, B.A., Newton, P., Lin, C.-T., Sibbritt, D., McLachlan, C.S., Clifton-Bligh, R., Morley, J.W., and Lal, S. (2022). Associations between Sleep Quality and Heart Rate Variability: Implications for a Biological Model of Stress Detection Using Wearable Technology. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095770"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.smrv.2016.02.003","article-title":"Circadian mechanisms of 24-h blood pressure regulation and patterning","volume":"33","author":"Smolensky","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7990","DOI":"10.1038\/s41598-021-87200-3","article-title":"Blood pressure dipping during REM and non-REM sleep in patients with moderate to severe obstructive sleep apnea","volume":"11","author":"BaHammam","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1378\/chest.09-2954","article-title":"Sleep and hypertension","volume":"138","author":"Calhoun","year":"2010","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1093\/ajh\/hpu071","article-title":"A review of evidence for the link between sleep duration and hypertension","volume":"27","author":"Gangwisch","year":"2014","journal-title":"Am. J. Hypertens."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11906-019-0938-7","article-title":"Sleep duration and blood pressure: Recent advances and future directions","volume":"21","author":"Makarem","year":"2019","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.smrv.2018.02.003","article-title":"Insomnia and hypertension: A systematic review","volume":"41","author":"Jarrin","year":"2018","journal-title":"Sleep Med. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3389\/fmed.2017.00231","article-title":"Techniques for non-invasive monitoring of arterial blood pressure","volume":"4","author":"Meidert","year":"2017","journal-title":"Front. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Poon, C.C.Y.C., and Zhang, Y.T. (2006, January 17\u201318). Cuff-less and Noninvasive Measurements of Arterial Blood Pressure by Pulse Transit Time. Proceedings of the 27th Annual International Conference of the Engineering in Medicine and Biology Society 2005, IEEE-EMBS 2005, Shanghai, China.","DOI":"10.1109\/IEMBS.2005.1615827"},{"key":"ref_21","first-page":"73","article-title":"A transducer for the continuous external measurement of arterial blood pressure","volume":"10","author":"Pressman","year":"1963","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jcrc.2013.06.012","article-title":"Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome","volume":"28","author":"Meidert","year":"2013","journal-title":"J. Crit. Care."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.4065\/mcp.2009.0336","article-title":"Noninvasive measurement of central vascular pressures with arterial tonometry: Clinical revival of the pulse pressure waveform?","volume":"85","author":"Nelson","year":"2010","journal-title":"Mayo Clin. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.bpa.2014.08.001","article-title":"Measurement of blood pressure","volume":"28","author":"BSaugel","year":"2014","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s10877-012-9336-2","article-title":"Noninvasive continuous beat-to-beat radial artery pressure via TL-200 applanation tonometry","volume":"26","author":"Dueck","year":"2012","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s00134-012-2617-x","article-title":"The T-Line TL-200 system for continuous non-invasive blood pressure measurement in medical intensive care unit patients","volume":"38","author":"Saugel","year":"2012","journal-title":"Intensive Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1469-8986.1981.tb03042.x","article-title":"Relationship of Pulse Transmission Times to Pre-ejection Period and Blood Pressure","volume":"18","author":"Newlin","year":"1981","journal-title":"Psychophysiology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1469-8986.1981.tb03038.x","article-title":"The Covariation of Blood Pressure and PLilse Transit Time in Hypertensive Patients","volume":"18","author":"Allen","year":"1981","journal-title":"Psychophysiology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1469-8986.1983.tb00899.x","article-title":"Pulse Transit Time and Blood Pressure: An Intensive Analysis","volume":"20","author":"Lane","year":"1983","journal-title":"Psychophysiology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sharma, M., Kumar, A., Mathew, G., Griggs, D., Ghirmai, T., Krishnan, S.K., Hsiai, T.K., Chiao, J.-C., and Cao, H. (2017). Cuff-Less and Continuous Blood Pressure Monitoring: A Methodological Review. Technologies, 5.","DOI":"10.3390\/technologies5020021"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1109\/MCAS.2018.2849261","article-title":"Towards a continuous non-invasive cuffless blood pressure monitoring system using PPG: Systems and circuits review","volume":"18","author":"Wang","year":"2018","journal-title":"IEEE Circuits Syst. Mag."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1109\/TBCAS.2019.2946661","article-title":"Cuffless blood pressure monitoring from an array of wrist bio-impedance sensors using subject-specific regression models: Proof of concept","volume":"13","author":"Ibrahim","year":"2019","journal-title":"IEEE Trans. Biomed. Circuits Syst."},{"key":"ref_33","first-page":"3469","article-title":"Pulse transit time and heart rate variability in sleep staging","volume":"2016","author":"Shahrbabaki","year":"2016","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1161\/01.CIR.91.7.1918","article-title":"Heart rate variability during specific sleep stages: A comparison of healthy subjects with patients after myocardial infarction","volume":"91","author":"Vanoli","year":"1995","journal-title":"Circulation"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/11\/5112\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:43:16Z","timestamp":1760125396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/11\/5112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,27]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["s23115112"],"URL":"https:\/\/doi.org\/10.3390\/s23115112","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,27]]}}}