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Autonomic pain responses during sleep: A study of heart rate variability
Author(s) -
Chouchoul F.,
Pichotl V.,
Perchetl C.,
Legrainl V.,
GarciaLarreal L.,
Rochel F.,
Bastujil H.
Publication year - 2011
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2010.11.011
Subject(s) - nociception , wakefulness , arousal , polysomnography , heart rate variability , heart rate , noxious stimulus , anesthesia , stimulus (psychology) , psychology , autonomic nervous system , medicine , stimulation , sleep onset , vigilance (psychology) , electroencephalography , neuroscience , apnea , insomnia , blood pressure , receptor , psychiatry , psychotherapist
The autonomic nervous system (ANS) reacts to nociceptive stimulation during sleep, but whether this reaction is contingent to cortical arousal, and whether one of the autonomic arms (sympathetic/parasympathetic) predominates over the other remains unknown. We assessed ANS reactivity to nociceptive stimulation during all sleep stages through heart rate variability, and correlated the results with the presence of cortical arousal measured in concomitant 32‐channel EEG. Fourteen healthy volunteers underwent whole‐night polysomnography during which nociceptive laser stimuli were applied over the hand. RR intervals (RR) and spectral analysis by wavelet transform were performed to assess parasympathetic (HF WV ) and sympathetic (LF WV and LF WV /HF WV ratio) reactivity. During all sleep stages, RR significantly decreased in reaction to nociceptive stimulations, reaching a level similar to that of wakefulness, at the 3rd beat post‐stimulus and returning to baseline after seven beats. This RR decrease was associated with an increase in sympathetic LF WV and LF WV /HF WV ratio without any parasympathetic HF WV change. Albeit RR decrease existed even in the absence of arousals, it was significantly higher when an arousal followed the noxious stimulus. These results suggest that the sympathetic‐dependent cardiac activation induced by nociceptive stimuli is modulated by a sleep dependent phenomenon related to cortical activation and not by sleep itself, since it reaches a same intensity whatever the state of vigilance.