Autonomic function classification and sleep quality among young adults in Central Java, Indonesia: A cluster analysis

Objective

Sleep regulation is linked to autonomic function, with sleep disruptions often indicating dysregulation in the autonomic nervous system (ANS). This study conducted a cluster to identify the autonomic function profiles associated with sleep quality.

Methods

This cross-sectional study was conducted in Banyumas Regency, Central Java, Indonesia, in February to April 2023, and recruited 437 individuals aged 18–26 years. Autonomic function was evaluated using heart rate variability parameters, including low-frequency, very-low-frequency, and high-frequency bands. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. A k-means cluster analysis was conducted to identify patterns in ANS activity across various clusters, and the optimal number of clusters was determined using the silhouette method.

Results

Three clusters of participants with poor sleep quality (n = 381) were identified. Cluster 1 (n = 95) exhibited normal overall activity, with low sympathetic nervous system (SNS) activity and high parasympathetic nervous system (PNS) activity; Cluster 2 (n = 81) exhibited high ANS and SNS activity and normal PNS activity; and Cluster 3 (n = 205) exhibited low PNS and ANS activity and normal PNS activity. Two clusters of participants with good sleep quality (n = 56) were identified. Cluster 1 (n = 11) exhibited high ANS and PNS activity and low SNS activity, and Cluster 2 (n = 45) exhibited low ANS and PNS activity and normal SNS activity.

Conclusion

Understanding autonomic function clusters is essential for developing techniques for measuring sleep quality in young adults and establishing effective health promotion programs.