Cardiac autonomic regulation during sleep in idiopathic REM sleep behavior disorder.
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.
Lanfranchi
Paola A
PA
Department of Medicine, Cardiology Division, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.
Fradette
Lorraine
L
Gagnon
Jean-François
JF
Colombo
Roberto
R
Montplaisir
Jacques
J
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
Am J Physiol. 1994 Feb;266(2 Pt 2):H548-54
8141356
Neurology. 2006 Mar 28;66(6):845-51
16567700
Neurology. 1992 Jul;42(7):1371-4
1620348
Neurology. 2000 Jul 25;55(2):281-8
10908906
Sleep. 1992 Apr;15(2):173-84
11032543
Hypertension. 2007 Jan;49(1):120-6
17101845
Neurology. 2004 May 25;62(10):1804-9
15159482
Circ Res. 1986 Aug;59(2):178-93
2874900
Ann Neurol. 2003 Jun;53(6):774-80
12783424
Biol Psychiatry. 1997 Sep 15;42(6):527-8
9285091
Circulation. 1991 Aug;84(2):482-92
1860193
Neurology. 2006 Dec 26;67(12):2236-8
17190953
N Engl J Med. 1993 Feb 4;328(5):303-7
8419815
Lancet Neurol. 2006 Jul;5(7):572-7
16781987
N Engl J Med. 1984 Oct 18;311(16):1006-10
6384778
Circulation. 1996 Mar 1;93(5):1043-65
8598068
Nucl Med Commun. 2003 Mar;24(3):267-71
12612467
J Neurol Sci. 2006 Feb 15;241(1-2):59-65
16325862
Lancet Neurol. 2006 May;5(5):424-32
16632313
Sleep. 1996 Jun;19(5):367-9
8843526
Neurology. 1998 Aug;51(2):363-70
9710004
Nature. 2005 Oct 27;437(7063):1279-85
16251953
Sleep. 2001 Jun 15;24(4):469-70
11403531
Sleep Med. 2007 Nov;8(7-8):760-7
17825617
Electroencephalogr Clin Neurophysiol. 1997 May;102(5):390-6
9191582
Lancet Neurol. 2006 Mar;5(3):235-45
16488379
Neurology. 2002 Dec 24;59(12):1889-94
12499479