Autonomic Nervous System Functioning Related to Nocturnal Sleep in Patients With Chronic Fatigue Syndrome Compared to Tired Controls

Orjatsalo, Maija; Alakuijala, Anniina; Partinen, Markku

doi:10.5664/jcsm.6924

Cited by 15 publications

(14 citation statements)

References 47 publications

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“…Slight inconsistencies between our results with previous research may be due to methodological differences. Orjatsalo et al 34 and Togo and Natelson 35 both conducted laboratory-based sleep assessments over 1 night so that participants may have been affected by the "first-night effect"; wherein their sleep was potentially disrupted on their first night of assessment while habituating to an unfamiliar environment and nighttime routine. In contrast, we assessed participants in their own home using a minimally invasive EEG device, removing the need for environmental familiarization, and thus potentially providing a more ecologically valid reflection of participants' regular nocturnal behavior and autonomic activity.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 However, few studies have investigated differences in autonomic activity across sleep stages for patients with CFS compared to healthy control participants. 34,35 Togo and Natelson 35 initially demonstrated that HRV was lower in all measured stages of sleep for patients with CFS, compared with healthy control participants. Orjatsalo and colleagues 34 found that it was only during SWS that HRV power was lower for patients with CFS than fatigued controls; although these controls had a diagnosis of either insomnia or delayed sleep phase syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…Despite promising results, these previous studies have some limitations. The sample size used by Orjatsalo et al 34 was relatively small, consisting of only eight patients with CFS, and eight controls. Further, only Togo and Natelson 35 correlated sleep characteristics with self-reported experience, showing that HRV was not related to sleepiness the following morning.…”

Section: Introductionmentioning

confidence: 99%

“…those with CFS does not appear to be explained exclusively by differences in sleep structure.Instead, patients with CFS have previously been shown to have reduced nocturnal HRV compared to healthy control patients 8,33. A previous study found that patients with CFS show reduced HRV specifically during SWS,34 although another study suggests that HRV is reduced during all stages of…”

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confidence: 98%

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Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome

Fatt

Beilharz

Joubert

et al. 2020

Journal of Clinical Sleep Medicine

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Study Objectives: Physiological dearousal characterized by an increase in parasympathetic nervous system activity is important for good-quality sleep. Previous research shows that nocturnal parasympathetic activity (reflected by heart rate variability [HRV]) is diminished in individuals with chronic fatigue syndrome (CFS), suggesting hypervigilant sleep. This study investigated differences in nocturnal autonomic activity across sleep stages and explored the association of parasympathetic activity with sleep quality and self-reported physical and psychological wellbeing in individuals with CFS. Methods: Twenty-four patients with medically diagnosed CFS, and 24 matched healthy control individuals participated. Electroencephalography and HRV were recorded during sleep in participants' homes using a minimally invasive ambulatory device. Questionnaires were used to measure self-reported wellbeing and sleep quality. Results: Sleep architecture in patients with CFS differed from that of control participants in slower sleep onset, more awakenings, and a larger proportion of time spent in slow-wave sleep (SWS). Linear mixed-model analyses controlling for age revealed that HRV reflecting parasympathetic activity (normalized high frequency power) was reduced in patients with CFS compared to control participants, particularly during deeper stages of sleep. Poorer self-reported wellbeing and sleep quality was associated with reduced parasympathetic signaling during deeper sleep, but not during wake before sleep, rapid eye movement sleep, or with the proportion of time spent in SWS. Conclusions: Autonomic hypervigilance during the deeper, recuperative stages of sleep is associated with poor quality sleep and self-reported wellbeing. Causal links need to be confirmed but provide potential intervention opportunities for the core symptom of unrefreshing sleep in CFS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 98%

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Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome

Fatt

Beilharz

Joubert

et al. 2020

Journal of Clinical Sleep Medicine

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“…One possible explanation might be that some patients who had been nearly bed-bound previously were able to remain awake during the daytime and begin working again after an improvement in their fatigue following the yoga intervention. HF becomes lower when patients with CFS are awake compared to when they are asleep [66–68]. Improved fatigue might lead to increased daily activity and thus a decrease in vagal activity.…”

Section: Discussionmentioning

confidence: 99%

The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study

Oka

Tanahashi

Lkhagvasuren

et al. 2019

BioPsychoSocial Med

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BackgroundIn a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice.MethodsFifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).ResultsPracticing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS (P = 0.002) and HADS-depression (P = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels (P = 0.048), the high frequency component of HR variability (P = 0.042), and TAS-20 scores (P = 0.001).ConclusionsRegular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients.Trial registrationUniversity Hospital Medical Information Network (UMIN CTR) UMIN000009646. Registered Dec 27, 2012.

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Wenn Belastungen zum Dauerzustand werden: Erschöpfung

Klösch

Hauschild

Zeitlhofer

2020

Ermüdung Und Arbeitsfähigkeit

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Autonomic Nervous System Functioning Related to Nocturnal Sleep in Patients With Chronic Fatigue Syndrome Compared to Tired Controls

Abstract: The results suggest a nocturnal dysfunction of the cardiac ANS in CFS, presenting as lower parasympathetic tone in deep sleep and higher sympathetic tone asleep.

Cited by 15 publications

References 47 publications

Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome

Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome

The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study

Wenn Belastungen zum Dauerzustand werden: Erschöpfung

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