Arousals are spontaneous activations of the central ner-
vous system (CNS) that cause a reaction in the auto-
nomic nervous system (ANS). We investigated transfer en-
tropy (TE) between CNS and ANS to characterize cardio-
cerebral coupling in patients with cardiovascular diseases
(CVDs) and healthy subjects. 2,154 recordings from the
Sleep Heart Healthy Study were investigated to find differ-
ences between both groups. CNS activity was measured
by EEG band power parameters, while activity in the ANS
was measured by various heart rate and QT interval vari-
ability parameters. To determinate the effect ρ of arousals,
TE was calculated before and after an arousal. Infor-
mation transfer from the CNS to parasympathetic domi-
nated parameters was stronger influenced due to arousal
(ρ = 1.126) compared to information transfer from CNS
to sympathetic dominated parameters (ρ = 1.118). Our
results indicate, that arousals lead to an activation of the
parasympathetic nervous system but also an increase in
the sympathetic response is necessary to return to home-
ostasis. The increase in information transfer due to an
arousal was significantly lower (p < 0.05) in patients with
CVD compared to healthy subjects, suggesting that CVD
inhibits the cardio-cerebral regulatory system. Our find-
ing may contribute to understand the pathophysiological
effects of CVD beyond the autonomic regulatory function.