title: Cardiac autonomic regulation during sleep in idiopathic REM sleep behavior disorder.
abstract: OBJECTIVE
  To assess cardiac autonomic and respiratory changes from stage 2 non-rapid eye movement sleep (NREM) to rapid eye movement (REM) sleep in subjects with idiopathic REM sleep behavior disorder (RBD) and controls. We tested the hypothesis that REM-related cardiorespiratory activation is altered in subjects with RBD.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  University hospital-based sleep research laboratory.
  
  
  METHODS
  Ten subjects with idiopathic RBD (2 women, mean age 63.4 +/- 6.2 years) and 10 sex- and age-matched controls (mean age 63.9 +/- 6.3 years).
  
  
  METHODS
  One-night polysomnography was used to assess R-R variability during NREM and REM sleep.
  
  
  RESULTS
  Spectral analysis of R-R interval and respiration were performed. Mean R-R interval, low-frequency (LF) and high-frequency (HF) components in both absolute and normalized units (LFnu and HFnu), and the LF/HF ratio were obtained from 5-minute electrocardiogram segments selected during NREM and REM sleep under stable conditions (stable breathing pattern, no microarousals or leg movements). Respiratory frequency was also assessed. Values obtained were then averaged for each stage and analyzed by 2 x 2 analysis of variance with group (RBD subjects and controls) as factor and state (NREM and REM) as repeated measures. RR interval, HF, and HFnu components decreased from NREM to REM in controls but did not change in RBD subjects (Interaction P < 0.05). LFnu (interaction P < 0. 001), LF/HF (interaction P < 0. 001), and respiratory frequency (interaction P < 0. 05) increased from NREM to REM sleep in controls but remained stable in RBD subjects.
  
  
  CONCLUSIONS
  REM-related cardiac and respiratory responses are absent in subjects with idiopathic RBD.
authors: Department of Medicine, Cardiology Division, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.
authors: Paola A
authors: PA
authors: Lanfranchi
authors: Lorraine
authors: L
authors: Fradette
authors: Jean-François
authors: JF
authors: Gagnon
authors: Roberto
authors: R
authors: Colombo
authors: Jacques
authors: J
authors: Montplaisir
mesh_terms: D000368:Aged; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000294:innervation*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D017286:Polysomnography; D012123:Pulmonary Ventilation / Q000502:physiology; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology; D012895:Sleep, REM / Q000502:physiology; D014851:Wakefulness / Q000502:physiology
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