Sleep Research Center, Hôpital du Sacré-Coeur de Montréal, Québec, Canada.
Sleep. 2010 Jan;33(1):113-22. doi: 10.1093/sleep/33.1.113.
To assess whether dysfunctional autonomic regulation during REM sleep as indexed by heart rate variability (HRV) is a pathophysiological factor in frequent nightmares (NMs).
Monitoring with polysomnography (PSG) and electrocardiography (ECG) for 3 consecutive nights: Night 1 (N1), adaptation night; N2, administration of partial REM sleep deprivation; N3, recovery night. Differences between NM and control (CTL) groups assessed for ECG measures drawn from wakefulness, REM sleep, and Stage 2 sleep on both N1 and N3.
Hospital-based sleep laboratory.
Sixteen subjects with frequent NMs (> or = 1 NM/week; mean age = 26.1 +/- 8.7 years) but no other medical or psychiatric disorders and 11 healthy comparison subjects ( < 1 NM/month; mean age = 27.1+/- 5.6 years).
NM and CTL groups differed on 2 REM sleep measures only on N1; the NM group had longer REM latencies and REM/NREM cycle durations than did the CTL group. No differences were found on time domain and absolute frequency domain ECG measures for either N1 or N3. However, altered HRV for the NM group was suggested by significantly higher LFnu, lower HFnu, and higher LF/HF ratio than for the CTL group.
Results are consistent with a higher than normal sympathetic drive among NM subjects which is unmasked by high REM sleep propensity. Results also support a growing literature linking anxiety disorders of several types (panic disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder) to altered HR variability.
评估 REM 睡眠期间自主神经调节功能障碍（以心率变异性 [HRV] 为指标）是否是频繁梦魇（NM）的病理生理因素。
连续 3 晚进行多导睡眠监测（PSG）和心电图（ECG）监测：第 1 晚（N1），适应期；第 2 晚，进行部分 REM 睡眠剥夺；第 3 晚，恢复期。在 N1 和 N3 时，比较 NM 组和对照组（CTL）的清醒、REM 睡眠和 Stage 2 睡眠时的 ECG 指标差异。
医院睡眠实验室。
16 名有频繁 NM（>或= 1 NM/周；平均年龄= 26.1 +/- 8.7 岁）但无其他医学或精神疾病的患者和 11 名健康对照者（< 1 NM/月；平均年龄= 27.1 +/- 5.6 岁）。
仅在 N1 时，NM 组和 CTL 组在 2 项 REM 睡眠指标上存在差异；NM 组的 REM 潜伏期和 REM/NREM 周期持续时间长于 CTL 组。在 N1 或 N3 时，时域和绝对频域 ECG 指标均无差异。然而，与 CTL 组相比，NM 组的 LFnu 更高、HFnu 更低、LF/HF 比值更高，提示 NM 组的 HRV 发生改变。
结果与 NM 患者的交感神经驱动高于正常一致，这在 REM 睡眠倾向高时被揭示出来。结果还支持越来越多的文献将几种类型的焦虑障碍（惊恐障碍、创伤后应激障碍 [PTSD]、广泛性焦虑障碍）与 HR 变异性改变联系起来。
