Clinical and Academic Unit of Sleep and Ventilation, Royal Brompton Hospital, Imperial College, London, UK.
Sleep Med. 2010 Jan;11(1):87-92. doi: 10.1016/j.sleep.2008.12.017. Epub 2009 Dec 4.
To determine if patients with autonomic failure have increased sleep disturbances and if multiple system atrophy (MSA) and pure autonomic failure (PAF) patients have frequent arousals from sleep associated with an attenuated heart rate (HR) response compared to healthy volunteers.
With informed consent, 10 autonomic failure patients and 10 healthy volunteers were studied. Sleep disturbances were scored using standard criteria. Arousals were identified from stage 2 sleep and differences in the R-R interval between groups were tested using a mixed-model regression analysis.
Three MSA and one PAF patient had obstructive sleep apnoea compared to one volunteer. One MSA and three PAF patients had periodic limb movements. One MSA patient had REM behaviour disorder. The autonomic patients had significantly reduced total sleep time (p=0.007) and sleep efficiency (p=0.003). The HR response to arousal was smaller in autonomic failure patients compared to volunteers during the early phase of the arousal (p=0.047), but not the later phase (p=0.67).
Autonomic failure patients have increased sleep disturbances compared to healthy volunteers. The smaller HR response in autonomic failure patients suggests that an intact sympathetic nervous system is a key component of the HR response associated with arousal from sleep.
确定自主神经衰竭患者是否存在睡眠障碍增加的情况，以及与健康志愿者相比，多系统萎缩（MSA）和单纯自主神经衰竭（PAF）患者是否存在频繁的睡眠觉醒，同时伴有心率（HR）反应减弱。
在获得知情同意的情况下，研究了 10 名自主神经衰竭患者和 10 名健康志愿者。使用标准标准对睡眠障碍进行评分。从 2 期睡眠中识别觉醒，并使用混合模型回归分析测试组间 R-R 间隔的差异。
与一名志愿者相比，三名 MSA 和一名 PAF 患者患有阻塞性睡眠呼吸暂停。一名 MSA 和三名 PAF 患者患有周期性肢体运动。一名 MSA 患者患有 REM 行为障碍。与志愿者相比，自主神经衰竭患者的总睡眠时间（p=0.007）和睡眠效率（p=0.003）明显降低。与志愿者相比，在觉醒的早期阶段，自主神经衰竭患者的 HR 反应较小（p=0.047），但在后期阶段则没有差异（p=0.67）。
与健康志愿者相比，自主神经衰竭患者的睡眠障碍明显增加。自主神经衰竭患者的 HR 反应较小提示，完整的交感神经系统是与睡眠觉醒相关的 HR 反应的关键组成部分。
