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Daytime sleepiness and neural cardiac modulation in sleep‐related breathing disorders
Author(s) -
LOMBARDI CAROLINA,
PARATI GIANFRANCO,
CORTELLI PIETRO,
PROVINI FEDERICA,
VETRUGNO ROBERTO,
PLAZZI GIUSEPPE,
VIGNATELLI LUCA,
DI RIENZO MARCO,
LUGARESI ELIO,
MANCIA GIUSEPPE,
MONTAGNA PASQUALE,
CASTIGLIONI PAOLO
Publication year - 2008
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2008.00659.x
Subject(s) - polysomnography , heart rate variability , excessive daytime sleepiness , baroreflex , medicine , breathing , multiple sleep latency test , sleep (system call) , sleep stages , cardiology , sleep and breathing , heart rate , anesthesia , sleep disorder , insomnia , apnea , psychiatry , blood pressure , computer science , operating system
Summary Sleep‐related breathing disorders are common causes of excessive daytime sleepiness, a socially and clinically relevant problem. Mechanisms responsible for daytime sleepiness are still largely unknown. We investigated whether specific alterations in autonomic cardiac modulation during sleep, commonly associated with sleep‐related breathing disorders, are related to excessive daytime sleepiness. Fifty‐three patients with sleep‐related breathing disorders underwent nocturnal polysomnography. Excessive daytime sleepiness was diagnosed as a Multiple Sleep Latency Test response less than or equal to 600 s. We explored the relation of excessive daytime sleepiness, objectively determined, with indices of autonomic cardiac regulation, such as baroreflex sensitivity and heart rate variability, with polysomnographic indices of the severity of sleep‐related breathing disorders and with quality of sleep. Patients with excessive daytime sleepiness, when compared with patients without, had significantly lower baroreflex sensitivity and significantly higher low‐to‐high frequency power ratio of heart rate variability during the different stages of nocturnal sleep. By contrast, no differences were found in indices quantifying the severity of sleep‐related breathing disorders or sleep quality. We demonstrated that excessive daytime sleepiness is accompanied by a deranged cardiac autonomic control at night, the latter probably reflecting autonomic arousals not detectable in the EEG. As abnormal autonomic regulation is also known to be associated with increased cardiovascular risk, a possible relation between excessive daytime sleepiness and cardiovascular events in patients with sleep‐related breathing disorders deserves to be investigated in future studies.