Autonomic dysfunction in isolated rapid eye movement sleep without atonia.
Daniel A Barone1, Matthew R Ebben1, Ashkan Samie1
1Weill Cornell Medical College Center for Sleep Medicine, USA.
Summary
Patients with isolated rapid eye movement sleep without atonia show reduced heart rate variability, indicating autonomic dysfunction. This finding aligns with previous studies on rapid eye movement sleep behavior disorder.
Area of Science:
- Neurology
- Sleep Medicine
- Autonomic Neuroscience
Background:
- Autonomic dysfunction is observed in rapid eye movement (REM) sleep behavior disorder (RBD) patients, evidenced by heart rate variability (HRV) changes.
- REM sleep behavior disorder is characterized by the absence of normal muscle paralysis during REM sleep, leading to acting out dreams.
Purpose of the Study:
- To investigate whether isolated REM sleep without atonia is associated with autonomic dysfunction.
- To compare HRV parameters in patients with isolated REM sleep without atonia versus those with normal REM atonia.
Main Methods:
- Retrospective analysis of 120 polysomnography records showing REM sleep without atonia.
- Exclusion of 99 records due to factors affecting HRV, leaving 21 records for analysis.
- Matched comparison of 21 patients with isolated REM sleep without atonia against 21 controls with normal REM atonia, including electrocardiogram analysis for HRV parameters (RR interval, standard deviation, power, VLF, LF, HF bands).
Main Results:
- Patients with isolated REM sleep without atonia exhibited significantly reduced HRV compared to controls.
- Statistically significant differences were found in RR standard deviation, HRV power, and the low-frequency band.
- A borderline significant reduction was observed in the high-frequency band, suggesting autonomic dysfunction.
Conclusions:
- The study confirms reduced HRV in patients with isolated REM sleep without atonia, supporting the hypothesis.
- These findings are consistent with autonomic dysfunction observed in REM sleep behavior disorder.
- This research is the first to report autonomic dysfunction in isolated REM sleep without atonia, highlighting the need for further clinical investigation.
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