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Cardiac Autonomic Modulation is Preserved During Sleep in Patients with Spinal Cord Injury
Author(s) -
Tobaldini Eleonora,
Proserpio Paola,
Sambusida Katrina,
Lanza Andrea,
Redaelli Tiziana,
Frigerio Pamela,
Fratticci Lara,
Somers Virend,
Nobili Lino,
Montano Nicola
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.831.5
Subject(s) - medicine , spinal cord injury , heart rate variability , sleep (system call) , autonomic nervous system , anesthesia , polysomnography , cardiology , autonomic dysreflexia , non rapid eye movement sleep , balance (ability) , spinal cord , heart rate , physical medicine and rehabilitation , blood pressure , apnea , eye movement , psychiatry , computer science , operating system , ophthalmology
Objectives. Spinal cord injuries (SCI) are associated with an altered cardiovascular autonomic control. Sympatho‐vagal balance varies across sleep stages but no data are available on the effects of SCI on cardiac autonomic regulation during sleep. We investigated changes of sympatho‐vagal balance during sleep in SCI patients. Methods. Polysomnographic (PSG) recordings were obtained in 27 patients with cervical (Cerv, n=12) and thoracic (Thor, n=15) SCI and in healthy subjects (Controls, n=8). ECG and respiration were extracted and divided into wake (W), non‐REM 2 and 3 (N2 and N3) and REM sleep stages. Autonomic control was assessed by means of symbolic analysis (SA), a non linear tool that identifies three main indices, 0V%, index of sympathetic modulation, 2LV% and 2UV%, markers of vagal modulation. Results. Total variability was reduced in SCI. SA showed a decrease of 0V% in N2 and N3 compared to W and REM; an increase of 2LV% and 2UV% in N2 and N3 compared to W and REM was observed. These modifications were independent by the level of the lesion and similarly to Controls. Conclusions In SCI patients, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, similar to Controls. Thus, cardiac autonomic dynamics throughout sleep stages are maintained in SCI, independently from the level of the lesion.