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Cardiovascular variability during periodic leg movements: a spectral analysis approach
Emilia Sforza1, Vincent Pichot, Jean Claude Barthelemy
1Laboratoire de Sommeil, Service de Psychiatrie Adulte, Hôpitaux Universitaires de Genève, Switzerland. emilia.sforza@hcuge.ch
Summary
Periodic leg movements during sleep (PLMS) increase sympathetic activity in restless legs syndrome patients. Heart rate variability (HRV) analysis reveals these autonomic changes, aiding in understanding PLMS impact.
Area of Science:
- Cardiology
- Sleep Medicine
- Autonomic Neuroscience
Background:
- Cardiovascular measures are sensitive markers for sleep events.
- Periodic leg movements during sleep (PLMS) are associated with restless legs syndrome (RLS).
- Understanding the impact of PLMS on heart rate variability (HRV) during sleep is crucial.
Purpose of the Study:
- To analyze the effects of PLMS on HRV during NREM sleep in RLS patients.
- To investigate changes in autonomic activity related to PLMS.
Main Methods:
- Measured HRV using spectral analysis (FFT), wavelet transform, and time/geometric domains.
- Compared HRV during NREM sleep stages (stage 2 and SWS) with and without PLMS (PLMS+ vs. PLMS-).
- Analyzed 14 RLS patients with PLMS, comparing 100 PLMS+ periods with 60 PLMS- periods.
Main Results:
- PLMS occurrence altered HRV geometrical indices, significantly increasing the triangular index (P < 0.0001).
- Low-frequency (LF) power significantly increased (P < 0.0001), indicating heightened sympathetic activity, while high-frequency (HF) power showed minimal change.
- HRV measures were lower when PLMS+ occurred during slow-wave sleep (SWS) compared to stage 2 NREM sleep.
Conclusions:
- PLMS is associated with increased sympathetic activity and stable parasympathetic activity.
- Frequency domain analysis of HRV effectively estimates autonomic changes related to PLMS.
- HRV spectral measures provide a simple method to assess autonomic changes in RLS patients with PLMS.