ECG Activity in the Sleep of Insomniac Patients under the Influence of Lormetazepam and Zopiclone

Jobert, Marc; Poiseau, Eric; Jähnig, Peter; Gaillard, Pierre; Schulz, Hartmut

doi:10.1159/000119195

Cited by 13 publications

(11 citation statements)

References 19 publications

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“…In fact the oral benzodiazepines, used for the treatment of insomnia and anxiety in community-dwelling subjects, unlike the intravenous ones [171], [172] have mostly been reported to have no effect on HRV [165], [167], [169], with some exception [166], [168]. Moreover, a recent and larger study in patients with schizophrenia [154], making no distinction between routes of administration, demonstrated that daily benzodiazepine dose was not associated with frequency-domain measures of HRV.…”

Section: Discussionmentioning

confidence: 99%

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

et al. 2014

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BackgroundMild cognitive impairment (MCI) is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.AimTo conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA) of heart rate variability (HRV) at rest and during provocative manoeuvres.MethodsThis cross-sectional study involved 80 older outpatients (aged ≥65) consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls) based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions—supine rest with free breathing (baseline), supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation), and active standing (orthosympathetic stimulation)—with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn) and high frequency (HFn) powers and the LF/HF ratio. Blood pressure (BP) was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.ResultsThere were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.ConclusionsOur study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will determine its prognostic relevance as a predictor of adverse health outcomes.

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Section: Discussionmentioning

confidence: 99%

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

et al. 2014

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“…Ultimately, 34 studies were identified that met the inclusion criteria for this review. Twenty six observational studies ([ 8 , 11 – 13 , 47 , 53 , 57 , 59 – 63 , 65 , 66 , 68 – 73 , 82 – 87 ]) and eight interventional studies ([ 64 , 67 , 74 – 78 , 88 ]). Study details such as diagnostic criteria, demographics, number of participants, insomnia severity, and type of intervention are presented in Tables 4 and 5 .…”

Section: Resultsmentioning

confidence: 99%

“…Jobert et al [ 88 ] compared the effect of pharmacologic treatment (benzodiazepine hypnotic lormetazepam and cyclopyrrolone hypnotic zopiclone) on HR activity in elderly patients with a diagnosis of psychophysiological insomnia. Their results showed that the relation between sleep and HR remained constant under the influence of a single dose of lormetazepam or zopiclone.…”

Section: Resultsmentioning

confidence: 99%

Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review

et al. 2017

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BackgroundInsomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly clear, it is generally assumed that cardiovascular autonomic modifications could occur as a result of sleeplessness, or, alternatively, that autonomic alterations could be an expression of a hyper-arousal state. This review investigates whether cardiovascular measures are different between insomniacs and controls.MethodsElectronic databases were systematically searched, and 34 studies were identified. Heart rate variability features, the association of cardiac and EEG activity, physiologic complexity measures, and cardiovascular activity, assessed by measures such as pre-ejection time, blood pressure, and heart rate dynamics were studied. Given the heterogeneity of the studies, a narrative synthesis of the findings was performed.ResultsThis review study found overall differences in cardiovascular activity between insomniacs and controls in most of the observational studies (21/26), while the expression of cardiovascular regulation varied between the examined insomniac groups. All the studies that investigated the association of cardiac activity and EEG power reported an altered relation between autonomic activity and EEG parameters in insomniacs.ConclusionAutonomic regulation tends to be consistent between insomniacs, as long as they are grouped according to their respective phenotype, as shown in the insomnia subgroup with objectively short sleep duration. Our hypothesis is that these differences in the expression of cardiovascular activity could be explained by the heterogeneity of the disorder. Therefore, the determination of insomnia phenotypes, and the study of cardiovascular measures, rather than heart rate variability alone, will give more insight into the link between insomnia and cardiovascular regulation. This study suggests that cardiovascular activity differs between insomniacs and controls. These new findings are of interest to clinicians and researchers for a more accurate insomnia assessment, and the development of personalized technological solutions in insomnia.

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“…12,19 Zopiclone adds no significant influence in ventilation, except a transient increase of breathing frequency after 5 min of injection (7.5 mg). 21 Its affect on electrocardiogram activity, 22 heart rate, and blood pressure 21,23 was also very slight in the treating dose of 7.5 mg. Therefore, it seems less likely that zopiclone would add a significant effect on PTT in patients with obstructive sleep apnea.…”

Section: Discussionmentioning

confidence: 98%

Is pulse transit time useful in differentiating respiratory events for patients with a sleep breathing disorder? A pilot study

Yin

Miyazaki

Itasaka

et al. 2004

Sleep and Biological Rhythms

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Variation of inspiratory effort in sleep disordered breathing induces the oscillation in blood pressure, which corresponds inversely to pulse transit time (PTT). This study evaluated the feasibility of PTT as a visual parameter for differentiating respiratory events in patients with a sleep breathing disorder. Sixteen patients who complained of snoring and sleep apnea were booked into the study. Polysomnographic data of Zopiclone induced daytime sleep were analyzed, PTT and intraesophageal pressure (Peso) were assessed for each respiratory event. With respect to Peso, the total accuracy of PTT was 51.8% for 1266 events. The relatively high coincidence rate could be observed in obstructive events (57.1%), with crescendo Peso pattern (71.5%), in lateral position (82.2%). Pulse transit time oscillation could only partly reflect respiratory rhythm to some degree (56.5%). Absolute PTT value presented a poor relationship with respiratory effort. Pulse transit time coincided well with crescendo Peso in lateral position for obstructive events. Swings in PTT could only partly fit respiratory wave data. Absolute PTT value and its change could not reflect respiratory effort. Although PTT is a non-invasive and convenient way for assessing inspiratory effort, its variable sensitivity to different events, respiratory patterns, positions, different patients and other situations, limit its feasibility. Further work is required.

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ECG Activity in the Sleep of Insomniac Patients under the Influence of Lormetazepam and Zopiclone

Cited by 13 publications

References 19 publications

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

Autonomic Dysfunction in Mild Cognitive Impairment: Evidence from Power Spectral Analysis of Heart Rate Variability in a Cross-Sectional Case-Control Study

Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review

Is pulse transit time useful in differentiating respiratory events for patients with a sleep breathing disorder? A pilot study

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