Association between Heart Rate Variability, Blood Pressure and Autonomic Activity in Cyclic Alternating Pattern during Sleep

Kondo, Hideaki; Ozone, Motohiro; Ohki, Noboru; Sagawa, Yohei; Yamamichi, Keiichirou; Fukuju, Mitsuki; Yoshida, Takeshi; Nishi, Chikako; Kawasaki, Akiko; Mori, Kaori; Kanbayashi, Takashi; Izumi, Motomori; Hishikawa, Yasuo; Nishino, Seiji; Shimizu, Tetsuo

doi:10.5665/sleep.3334

Cited by 22 publications

(12 citation statements)

References 38 publications

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“…Compared to healthy controls, ALS patients presented a significant reduction of CAP time and CAP rate and an inversion of A1/A3 ratio due to the reduced amounts of A1 subtypes and the increased amounts of A3 phases. The strong relationship between ANS activity and sleep microstructure, 40 the "inverted" CAP-related A1/A3 ratio and the predominance of light sleep indicate a shift toward an increased sympathetic tone and a reduction of parasympathetic activity during sleep in ALS patients. In addition, a subclinical involvement of cardiac ANS, mostly of vagal nerve efferents, and was demonstrated by HRV assessment during both sleep (NREM and REM) and wakefulness.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, no significant correlation between CAP metrics and HRV parameters was not found in ALS patients, suggesting a degeneration of the central neural network involved in the generation of CAP and in the control of the ANS, that seem to be functionally interconnected. 40 In particular, the thalamo-cortical pathways, which modulate the transient EEG oscillations that characterize the phases A of CAP, 40 are known to be linked to the limbic system and a large area extended from hypothalamus to medulla oblungata. 45 Involvement of hypothalamus in ALS has been documented by several studies showing hypothalamic TDP-43 inclusions or hypothalamus atrophy (also present in familial presymptomatic gene carriers) and appears to be correlated to early onset and disease progression.…”

Section: Discussionmentioning

confidence: 99%

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Sleep cardiac dysautonomia and EEG oscillations in amyotrophic lateral sclerosis

Congiu

Mariani

Milioli

et al. 2019

Sleep

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Study Objectives Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease due to loss of motor neurons. However, the autonomic nervous system (ANS) can also be involved. The aim of this research was to assess the sleep macro- and microstructure, the cardiac ANS during sleep, and the relationships between sleep, autonomic features, and clinical parameters in a cohort of ALS patients. Methods Forty-two consecutive ALS patients underwent clinical evaluation and full-night video-polysomnography. Only 31 patients met inclusion criteria (absence of comorbidities, intake of cardioactive drugs, or recording artifacts) and were selected for assessment of sleep parameters, including cyclic alternating pattern (CAP) and heart rate variability (HRV). Subjective sleep quality and daytime vigilance were also assessed using specific questionnaires. Results Although sleep was subjectively perceived as satisfactory, compared with age- and sex-matched healthy controls, ALS patients showed significant sleep alteration: decreased total sleep time and sleep efficiency, increased nocturnal awakenings, inverted stage 1 (N1)/stage 3 (N3) ratio, reduced REM sleep, and decreased CAP rate, the latter supported by lower amounts of A phases with an inverted A1/A3 ratio. Moreover, a significant reduction in HRV parameters was observed during all sleep stages, indicative of impaired autonomic oscillations. Conclusion Our results indicate that sleep is significantly disrupted in ALS patients despite its subjective perception. Moreover, electroencephalogram activity and autonomic functions are less reactive, as shown by a decreased CAP rate and a reduction in HRV features, reflecting an unbalanced autonomic modulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sleep cardiac dysautonomia and EEG oscillations in amyotrophic lateral sclerosis

Congiu

Mariani

Milioli

et al. 2019

Sleep

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“…Sleep is also an important regulator of circadian rhythm, which is associated with the development of CVD 47 , and individuals with poor sleep quality may have disturbed circadian rhythms. Kondo et al reported that the cyclic alternating pattern during sleep was associated with heart rate variability, blood pressure, and autonomic activity 48 , which could also affect the development of CVD. Meier-Ewert et al demonstrated that sleep disorders were associated with elevated serum C-reactive protein levels, suggesting that inadequate sleep may cause chronic inflammation 49 , which plays a pivotal role in the pathology of various CVDs 50 , 51 .…”

Section: Discussionmentioning

confidence: 99%

Restfulness from sleep and subsequent cardiovascular disease in the general population

Kaneko

Itoh

Kohno

et al. 2020

Sci Rep

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We aimed to clarify the association between restfulness from sleep and subsequent risk of cardiovascular disease (CVD). Medical records of 1,980,476 individuals with neither prior history of CVD nor sleep disorders were extracted from the Japan Medical Data Center. Restfulness from sleep was subjectively assessed using information from the questionnaires at initial health check-ups. The mean age was 45 ± 11 years and 1,184,937 individuals were men. Overall, 1,197,720 individuals (60.5%) reported having good restfulness from sleep. The mean follow-up period was 1122 ± 827 days. Myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation occurred in 3673 (0.2%), 30,241 (1.5%), 13,546 (0.7%), 28,296 (1.4%), and 8116 (0.4%) individuals, respectively. Multivariable Cox regression analyses including age, sex, and other CVD risk factors after multiple imputation for missing values showed that good restfulness from sleep was associated with lower incidence of myocardial infarction (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.83–0.95), angina pectoris (HR 0.85, 95% CI 0.83–0.87), stroke (HR 0.85, 95% CI 0.82–0.88), heart failure (HR 0.86, 95% CI 0.84–0.88), and atrial fibrillation (HR 0.93, 95% CI 0.89–0.97). The association of restfulness from sleep with CVD events was pronounced in subjects with younger age and female sex. In conclusion, good restfulness from sleep may be associated with the lower risk of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Further studies are required to clarify the underlying mechanism and to develop a novel preventive approach for CVD from the perspective of sleep.

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“…Lecci et al ( 2017 ) showed that the heart rate increases/declines together with the sigma-ISO with a lag of about 5 s in humans. Peaks in heart rate are also coupled with CAP phase A (Ferri et al, 2000 ; Kondo et al, 2014 ). This might suggest a synchronization between the sigma-ISO and CAP phase A, in contrast with the previous arguments based on sleep spindles and susceptibility to external stimuli.…”

Section: Heart Rate Changesmentioning

confidence: 99%

Commentary: Coordinated infraslow neural and cardiac oscillations mark fragility and offline periods in mammalian sleep

Manconi¹,

Silvani

Ferri

2017

Front. Physiol.

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Association between Heart Rate Variability, Blood Pressure and Autonomic Activity in Cyclic Alternating Pattern during Sleep

Abstract: All phase A subtypes were accompanied with increased heart rate variability, and the largest heart rate variability was seen in subtype A3, while a tendency for less heart rate variability was seen in subtype A1.

Cited by 22 publications

References 38 publications

Sleep cardiac dysautonomia and EEG oscillations in amyotrophic lateral sclerosis

Sleep cardiac dysautonomia and EEG oscillations in amyotrophic lateral sclerosis

Restfulness from sleep and subsequent cardiovascular disease in the general population

Commentary: Coordinated infraslow neural and cardiac oscillations mark fragility and offline periods in mammalian sleep

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