Heart rate variability and autonomic function in health professions students: Associations with academic stress and lifestyle factors

Abstract

Heart rate variability (HRV) is a non-invasive measure of autonomic nervous system function and a sensitive marker of physiological stress. Health professions students are exposed to severe academic stress and multiple lifestyle-related factors that may influence autonomic regulation. This study aimed to evaluate HRV profiles in health professions students and examine associations with academic stress and lifestyle factors. A cross-sectional study was conducted among 237 students (81.4% females). HRV was assessed under standardized resting conditions using time-domain, frequency-domain, and Poincaré plot-derived geometrical indices. Autonomic status was classified as normal autonomic function (NAF), low HRV (LHRV), parasympathetic dominance (PD), or sympathetic dominance (SD). Associations with body mass index, smoking, physical activity, sleep quality, and perceived stress were analyzed using chi-square and correlation tests. Normal autonomic function was observed in 65.0% of students, while 35.0% exhibited autonomic imbalance (16.9% PD, 16.9% SD, and 1.3% LHRV). No significant associations were found with lifestyle factors (p > 0.05). Perceived academic stress was significantly associated with autonomic imbalance among females (p = 0.013). In conclusion, most students demonstrated preserved autonomic function, although approximately one-third showed autonomic imbalance. Academic stress was significantly associated with autonomic function, particularly among female students.