Document Detail

Daytime sleepiness and neural cardiac modulation in sleep-related breathing disorders.
MedLine Citation:
PMID:  18503513     Owner:  NLM     Status:  MEDLINE    
Sleep-related breathing disorders are common causes of excessive daytime sleepiness, a socially and clinically relevant problem. Mechanisms responsible for daytime sleepiness are still largely unknown. We investigated whether specific alterations in autonomic cardiac modulation during sleep, commonly associated with sleep-related breathing disorders, are related to excessive daytime sleepiness. Fifty-three patients with sleep-related breathing disorders underwent nocturnal polysomnography. Excessive daytime sleepiness was diagnosed as a Multiple Sleep Latency Test response less than or equal to 600 s. We explored the relation of excessive daytime sleepiness, objectively determined, with indices of autonomic cardiac regulation, such as baroreflex sensitivity and heart rate variability, with polysomnographic indices of the severity of sleep-related breathing disorders and with quality of sleep. Patients with excessive daytime sleepiness, when compared with patients without, had significantly lower baroreflex sensitivity and significantly higher low-to-high frequency power ratio of heart rate variability during the different stages of nocturnal sleep. By contrast, no differences were found in indices quantifying the severity of sleep-related breathing disorders or sleep quality. We demonstrated that excessive daytime sleepiness is accompanied by a deranged cardiac autonomic control at night, the latter probably reflecting autonomic arousals not detectable in the EEG. As abnormal autonomic regulation is also known to be associated with increased cardiovascular risk, a possible relation between excessive daytime sleepiness and cardiovascular events in patients with sleep-related breathing disorders deserves to be investigated in future studies.
Carolina Lombardi; Gianfranco Parati; Pietro Cortelli; Federica Provini; Roberto Vetrugno; Giuseppe Plazzi; Luca Vignatelli; Marco Di Rienzo; Elio Lugaresi; Giuseppe Mancia; Pasquale Montagna; Paolo Castiglioni
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-20
Journal Detail:
Title:  Journal of sleep research     Volume:  17     ISSN:  1365-2869     ISO Abbreviation:  J Sleep Res     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-10     Completed Date:  2009-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214441     Medline TA:  J Sleep Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  263-70     Citation Subset:  IM    
Center for Sleep Disorders, Department of Neurological Sciences, University of Bologna, Bologna, Italy.
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MeSH Terms
Arousal / physiology
Autonomic Nervous System / physiopathology*
Baroreflex / physiology
Blood Pressure / physiology*
Circadian Rhythm / physiology
Disorders of Excessive Somnolence / diagnosis,  physiopathology*
Fourier Analysis
Heart / innervation*
Heart Rate / physiology*
Middle Aged
Reference Values
Signal Processing, Computer-Assisted
Sleep Apnea, Obstructive / diagnosis,  physiopathology*
Sleep Stages / physiology
Snoring / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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