Sleep Unit and Clinical Neurophysiology Section, University Clinic of Navarra, Pamplona, Spain.
Clin Neurophysiol. 2013 Jun;124(6):1163-8. doi: 10.1016/j.clinph.2012.12.042. Epub 2013 Jan 29.
Cardiac physiology during sleep in Parkinson's disease (PD) remains poorly explored. We studied heart rate variability (HRV) across sleep stages in PD patients and correlated the results with clinical features.
Cross-sectional study comprising 33 patients with PD and 29 controls matched for age, gender, and number of apneas/hypopneas per hour. HRV measures, (mean R-R interval, SDNN, ULF, VLF, LF, HF and LF/HF) were calculated separately for all sleep stages as well as wakefulness just before and after sleep during one-night polysomnography. Correlation analysis was performed between HRV values and PD patients' characteristics.
The mean R-R interval was lower in all sleep stages in PD patients when compared with controls. VLF and LF were lower during REM sleep in PD patients. HF during N1-N2 stage was higher in PD. We found inverse correlations between VLF and LF during REM sleep and UPDRS-ON and UPDRS-OFF.
VLF and LF during REM sleep might constitute surrogate markers of disease severity.
These findings provide additional clinical evidence of the autonomic impairment commonly observed in PD, and prove that cardiac autonomic dysfunction during REM sleep is correlated with disease severity.
帕金森病（PD）患者睡眠期间的心脏生理学仍未得到充分研究。我们研究了 PD 患者在睡眠各阶段的心率变异性（HRV），并将结果与临床特征相关联。
这是一项包含 33 名 PD 患者和 29 名匹配年龄、性别和每小时呼吸暂停/低通气次数的对照组的横断面研究。在一夜多导睡眠图中，分别计算了所有睡眠阶段以及睡眠前后清醒状态下的 HRV 指标（平均 R-R 间隔、SDNN、ULF、VLF、LF、HF 和 LF/HF）。对 HRV 值与 PD 患者特征之间进行了相关性分析。
与对照组相比，PD 患者在所有睡眠阶段的平均 R-R 间隔均较低。PD 患者 REM 睡眠期间的 VLF 和 LF 较低。PD 患者 N1-N2 期的 HF 较高。我们发现 REM 睡眠期间的 VLF 和 LF 与 UPDRS-ON 和 UPDRS-OFF 呈负相关。
REM 睡眠期间的 VLF 和 LF 可能是疾病严重程度的替代标志物。
这些发现为 PD 中常见的自主神经损伤提供了额外的临床证据，并证明 REM 睡眠期间的心脏自主神经功能障碍与疾病严重程度相关。
