Attenuated heart rate response in REM sleep behavior disorder and Parkinson's disease

Abstract

The objective of this study was to determine whether patients with Parkinson's disease with and without rapid-eye-movement sleep behavior disorder and patients with idiopathic rapid-eye-movement sleep behavior disorder have an attenuated heart rate response to arousals or to leg movements during sleep compared with healthy controls. Fourteen and 16 Parkinson's patients with and without rapid-eye-movement sleep behavior disorder, respectively, 11 idiopathic rapid-eye-movement sleep behavior disorder patients, and 17 control subjects underwent 1 night of polysomnography. The heart rate response associated with arousal or leg movement from all sleep stages was analyzed from 10 heartbeats before the onset of the sleep event to 15 heartbeats following onset of the sleep event. The heart rate reponse to arousals was significantly lower in both parkinsonian groups compared with the control group and the idiopathic rapid-eye-movement sleep behavior disorder group. The heart rate response to leg movement was significantly lower in both Parkinson's groups and in the idiopathic rapid-eye-movement sleep behavior disorder group compared with the control group. The heart rate response for the idiopathic rapid-eye-movement sleep behavior disorder group was intermediate with respect to the control and the parkinsonian groups. The attenuated heart rate response may be a manifestation of the autonomic deficits experienced in Parkinson's disease. The idiopathic rapid-eye-movement sleep behavior disorder patients not only exhibited impaired motor symptoms but also incipient autonomic dysfunction, as revealed by the attenuated heart rate response.

Cardiovascular autonomic dysfunctions and sleep disorders

“…A blunted HR increase associated with PLMS was later observed in iRBD patients compared to patients with RLS [138]. Similarly, a blunted HR increase in response to arousal and leg movements during sleep was found in iRBD patients compared to controls [139].…”

“…Interestingly, the HR response of iRBD patients was intermediate with respect to a control group and a group of PD patients presenting the lowest HR response to arousal and leg movements [139]. Finally, iRBD patients do not show the physiological parasympathetic withdrawal and sympathetic prevalence observed on passing from NREM to REM sleep [140].…”

Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease

“…Several studies have focused on analysis of sleep data in the search for PD biomarkers (Dos Santos et al, 2014). These have examined measures of sleep spindle densities, RSWA, slow wave characteristics (Christensen et al, 2014b;Kempfner et al, 2014a,b;Latreille et al, 2014Latreille et al, , 2011Postuma et al, 2010) and other measures of abnormalities of brain stem function, including autonomic functions such as heart-rate variability (Sorensen et al, 2013a(Sorensen et al, , 2012 and other non-motor symptoms (Garcia-Ruiz et al, 2014;Sakakibara et al, 2014).…”

Study of Sleep Patterns Might Advance Our Knowledge on Alertness in Traumatic Brain Injury

“…Sorensen et al [36] investigated whether patients with PD with and without RBD and patients with idiopathic RBD had an attenuated heart rate response to arousals or to leg movements during sleep compared with healthy controls [36].The researchers found heart rate response to arousals and leg movements to be significantly lower in both Parkinsonian groups compared with the control group and the idiopathic RBD group. They proposed that the attenuated heart rate response may be a manifestation of the autonomic deficits experienced in PD.…”