Diurnal and nocturnal cardiovascular variability and heart rate arousal response in idiopathic hypersomnia

Publication date: Available online 23 August 2016
Source:Sleep Medicine
Author(s): Emilia Sforza, Frédéric Roche, Jean Claude Barthélémy, Vincent Pichot
ObjectivesAutonomic 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).MethodsFourteen drug-free patients aged 26.2±7 years and fourteen age-matched controls were examined. Clinical data, 24-h polysomnography, heart rate (HR) variability and the HR response to spontaneous arousal were available.ResultsSleep 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 low frequency (LF) and LFnu 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-movements 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.ConclusionsIn 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.



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