title: Sleep-mediated heart rate variability after bilateral carotid body tumor resection.
abstract: OBJECTIVE
  The carotid bodies are thought to play an important role in sleep-dependent autonomic changes. Patients who underwent resection of bilateral carotid body tumors have chronically attenuated baroreflex sensitivity. These subjects provide a unique opportunity to investigate the role of the baroreflex during sleep.
  
  
  METHODS
  One-night ambulatory polysomnography (PSG) recording.
  
  
  METHODS
  Participants' homes.
  
  
  METHODS
  Nine patients with bilateral carotid body tumor resection (bCBR) (four women, mean age 50.4 ± 7.2 years) and nine controls matched for age, gender, and body mass index.
  
  
  METHODS
  N/A.
  
  
  METHODS
  Sleep parameters were obtained from PSG. Heart rate (HR) and its variability were calculated using 30-s epochs.
  
  
  RESULTS
  In bCBR patients, HR was slightly but not significantly increased during wake and all sleep stages. The effect of sleep on HR was similar for patients and controls. Low frequency (LF) power of the heart rate variability spectrum was significantly lower in bCBR patients in active wakefulness, sleep stage 1 and REM sleep. No differences were found between patients and controls for high frequency (HF) power and the LF/HF ratio.
  
  
  CONCLUSIONS
  Bilateral carotid body tumor resection (bCBR) is associated with decreased low frequency power during sleep, suggesting impaired baroreflex function. Despite this, sleep-related heart rate changes were similar between bCBR patients and controls. These findings suggest that the effects of sleep on heart rate are predominantly generated through central, non-baroreflex mediated pathways.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Nicolasine D
authors.initials: ND
authors.lastname: Niemeijer
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Eleonora P M
authors.initials: EP
authors.lastname: Corssmit
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Robert H A M
authors.initials: RH
authors.lastname: Reijntjes
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.|Sleep Wake Center SEIN, Heemstede, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: Lammers
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: J Gert
authors.initials: JG
authors.lastname: van Dijk
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.|SEIN, Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands.
authors.forename: Roland D
authors.initials: RD
authors.lastname: Thijs
mesh_terms: D001341:Autonomic Nervous System / Q000502:physiology; D017704:Baroreflex / Q000502:physiology*; D015992:Body Mass Index; D002344:Carotid Body / Q000502:physiology / Q000601:surgery*; D002345:Carotid Body Tumor / Q000601:surgery*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology; D014851:Wakefulness / Q000502:physiology
keywords: Heart rate variability; baroreflex; carotid body tumor; paraganglioma; sleep