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Sleep syncope: a prospective cohort study.

David L Jardine1, Jonathan Davis2, Christopher M Frampton3

  • 1Department of General Medicine, Christchurch Hospital, Riccarton Ave, Christchurch, New Zealand. david.jardine@cdhb.health.nz.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|January 8, 2022
PubMed
Summary
This summary is machine-generated.

Sleep syncope, a form of vasovagal syncope interrupting sleep, shares characteristics with classical vasovagal syncope but has a very good prognosis. Most patients respond to education and reassurance, with few requiring pacemakers.

Keywords:
Permanent pacemakerReflex syncopeTilt testVasovagal syncope

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Area of Science:

  • Cardiology
  • Neurology
  • Sleep Medicine

Background:

  • Sleep syncope is a distinct subtype of vasovagal syncope characterized by its occurrence during sleep.
  • Long-term follow-up data for sleep syncope patients have been limited, hindering a full understanding of its prognosis.

Purpose of the Study:

  • To define sleep syncope and compare its long-term outcomes with classical vasovagal syncope.
  • To investigate the demographic, clinical, and physiological characteristics of sleep syncope patients.

Main Methods:

  • A retrospective study comparing 69 sleep syncope patients with 118 classical vasovagal syncope patients.
  • Analysis included baseline demographics, syncope history, tilt table test results, and long-term follow-up data.
  • Comparison of mortality, pacemaker insertion rates, and syncope recurrence between the two groups.

Main Results:

  • Sleep syncope patients exhibited higher rates of abdominal discomfort, vagotonia, childhood syncope, and blood-needle phobia compared to classical vasovagal syncope.
  • Tilt table test results and physiological responses during syncope were similar between the groups.
  • Long-term follow-up showed similar mortality and pacemaker insertion rates; sleep syncope episodes significantly decreased over time.

Conclusions:

  • Sleep syncope is a subtype of vasovagal syncope with specific associated symptoms.
  • Despite the disruptive nature of sleep syncope episodes, the long-term prognosis is favorable.
  • Effective management primarily involves patient education and reassurance, with minimal need for permanent pacing.