Diurnal and nocturnal cardiovascular variability and heart rate arousal response in idiopathic hypersomnia.
Autonomic nervous system dysfunction has been described in narcolepsy with cataplexy affecting sympathetic functions. In this study we analyzed whether altered diurnal and nocturnal cardiovascular control is present in idiopathic hypersomnia (IH).



Fourteen drug-free patients aged 26.2 ± 7 years and 14 age-matched controls were examined. Clinical data, 24-h polysomnography, heart rate (HR) variability, and the HR response to spontaneous arousal were available.



Sleep macrostructure was comparable between controls and patients, with the latter having significantly longer sleep time, a higher number of sleep cycles (p < 0.0001), and low sleep efficiency (p < 0.01). The HR variability indices did not differ between groups, except for the rise of high frequency (HF) and HFnu in patients (p < 0.05) associated with blunted sympathetic indices (p < 0.01). These parasympathetic alterations were present for light, slow wave, and rapid eye-movement sleep and persisted for all sleep cycles. Compared to controls, the HR arousal response was significantly higher (p < 0.01) in patients starting before the arousal onset and persisting into the post-arousal period.



In IH patients a dysfunction of the parasympathetic activity during awake and sleep and an altered autonomic response to arousals are present. These findings suggest an impaired parasympathetic function that may explain some vegetative symptoms present in this type of central hypersomnia.
Service de Physiologie Clinique et de l'Exercice (Pole Hospitalier NOL), CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, SNA EPIS EA 4607, PRES de Lyon, France. Electronic address: emilia.sforza@gmail.com.
Emilia
E
Sforza
Service de Physiologie Clinique et de l'Exercice (Pole Hospitalier NOL), CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, SNA EPIS EA 4607, PRES de Lyon, France.
Frédéric
F
Roche
Service de Physiologie Clinique et de l'Exercice (Pole Hospitalier NOL), CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, SNA EPIS EA 4607, PRES de Lyon, France.
Jean Claude
JC
Barthélémy
Service de Physiologie Clinique et de l'Exercice (Pole Hospitalier NOL), CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, SNA EPIS EA 4607, PRES de Lyon, France.
Vincent
V
Pichot
D000328:Adult; D001143:Arousal / Q000502:physiology*; D001341:Autonomic Nervous System / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D020177:Idiopathic Hypersomnia / Q000503:physiopathology*; D008297:Male; D017286:Polysomnography; D012890:Sleep / Q000502:physiology
Autonomic arousal response; Heart rate; Idiopathic hypersomnia; Parasympathetic activity