Uyku Hastalıklarında Gelişebilecek Otonomik Değişikliklerin Kalp Hızı Değişkenliği ile Tespiti

Abstract

It is known that sleep disorders are associated with cardiovascular and cerebrovascular morbidity and mortality. The role of the autonomic system dysfunctions in this is discussed. The aim of our study was to evaluate heart rate variability (HRV), which is a marker of autonomic function, in sleep disorders frequently encountered sleep disorders, such as narcolepsy and REM Behavioural Disorders (RBD) in neurology sleep outpatient clinics and to compare, that with healthy controls. 26 patients who were diagnosed with narcolepsy according to ICSD 3 and 10 patients who matched the RBD criteria were included in this study from the patients who were admitted to Hacettepe University Neurology Department Polisomnography (PSG) laboratory. PSG findings of patients and ECG data of PSG recordings were examined. HRV analysis of all patients by means of time and frequency dependent automatic analysis; in different sleep stages and multiple sleep latency tests (MSLT) were calculated. LF and LF / HF values increased in NREM Stage 2 in narcolepsy patients(p=0.025; p=0.008). The lower RMSSD value during REM sleep stage in narcoleptic patients with cataplexy than without cataplexy was remarkable (p=0.041). In SOREM (-) the SDNN score was significantly lower (p=0.018) in comparison with SOREM (+). SDNN values in REM was found to be decreased in RBD patients compared to control group (p=0.004) . As a result, it has been observed that HRV was decreased in REM, especially in narcoleptic patients with cataplexy. As supporting findings of previous few studies in the literature, it has been shown that HRV is decreased during REM in RBD patients. Also the abnormalities in HRV were less pronounced in narcoleptic patients having sleep onset REM during their raps than who did not have. These our HRV findings which can show the possible risks of morbidity and mortality in narcolepsy and RBD patients who have cardiac autonomic dysfunction during sleep, would be important in preventive medicine if these will be supported by further long-term prospective studies