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Sleep architecture and attenuated heart rate response to arousal from sleep in patients with autonomic failure.

Abstract：

OBJECTIVE:To determine if patients with autonomic failure have increased sleep disturbances and if multiple system atrophy (MSA) and pure autonomic failure (PAF) patients have frequent arousals from sleep associated with an attenuated heart rate (HR) response compared to healthy volunteers. METHODS:With informed consent, 10 autonomic failure patients and 10 healthy volunteers were studied. Sleep disturbances were scored using standard criteria. Arousals were identified from stage 2 sleep and differences in the R-R interval between groups were tested using a mixed-model regression analysis. RESULTS:Three MSA and one PAF patient had obstructive sleep apnoea compared to one volunteer. One MSA and three PAF patients had periodic limb movements. One MSA patient had REM behaviour disorder. The autonomic patients had significantly reduced total sleep time (p=0.007) and sleep efficiency (p=0.003). The HR response to arousal was smaller in autonomic failure patients compared to volunteers during the early phase of the arousal (p=0.047), but not the later phase (p=0.67). CONCLUSION:Autonomic failure patients have increased sleep disturbances compared to healthy volunteers. The smaller HR response in autonomic failure patients suggests that an intact sympathetic nervous system is a key component of the HR response associated with arousal from sleep.

journal_name

Sleep Med

journal_title

Sleep medicine

authors

Freilich S,Goff EA,Malaweera AS,Twigg GL,Simonds AK,Mathias CJ,Morrell MJ

doi

10.1016/j.sleep.2008.12.017

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

87-92

issue

1

eissn

1389-9457

issn

1878-5506

pii

S1389-9457(09)00299-8

journal_volume

11

pub_type

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