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Autonomic functioning during REM sleep differentiates IBS symptom subgroups
Jennifer J Thompson1, Sigrid Elsenbruch, Michael J Harnish
1Lynn Institute for Healthcare Research, Oklahoma City, Oklahoma 73112, USA.
The American Journal of Gastroenterology
|December 21, 2002
Summary
Irritable bowel syndrome (IBS) patients with only lower bowel symptoms show greater sympathetic nervous system activity during REM sleep due to vagal withdrawal. This autonomic dysfunction during sleep may help differentiate IBS subgroups.
Area of Science:
- Gastroenterology
- Autonomic Neuroscience
- Sleep Medicine
Background:
- Irritable bowel syndrome (IBS) is a common gastrointestinal disorder.
- Autonomic nervous system dysfunction is implicated in IBS pathophysiology.
- Heart rate variability (HRV) analysis is a non-invasive tool to assess autonomic activity.
Purpose of the Study:
- To investigate autonomic activity using HRV analysis in IBS patients.
- To stratify IBS patients into subgroups based on symptoms.
- To explore differences in autonomic functioning during sleep stages between IBS subgroups and healthy controls.
Main Methods:
- Recruited 33 female IBS patients and 21 healthy female controls.
- Stratified IBS patients into IBS-only (lower bowel symptoms) and IBS+D (lower bowel and dyspeptic symptoms) groups.
- Utilized polysomnography and electrocardiography to measure HRV during presleep waking, NREM stage 2, and REM sleep.
- Analyzed HRV using spectral analysis to determine high-frequency (HF) power (vagal tone) and low-frequency/high-frequency (LF/HF) ratio (sympathovagal balance).
Main Results:
- IBS-only patients exhibited significantly lower HF power during REM sleep, indicating vagal withdrawal.
- IBS-only patients showed a significantly higher LF/HF ratio during REM sleep compared to IBS+D patients and controls.
- These findings suggest increased sympathetic dominance in IBS-only patients during REM sleep.
Conclusions:
- IBS-only patients demonstrate heightened sympathetic activity and vagal withdrawal specifically during REM sleep.
- Autonomic functioning during REM sleep can differentiate between IBS symptom subgroups.
- REM sleep autonomic patterns may serve as a potential biomarker for identifying distinct IBS patient populations.