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Cardiovascular variability during periodic leg movements: a spectral analysis approach.
Clin Neurophysiol. 2005 May; 116(5):1096-104.CN

Abstract

OBJECTIVE

Changes in cardiovascular measures have been advocated as sensitive markers of phasic events arising from sleep. The current study was aimed to analyse the effects of periodic leg movements (PLMS) on heart rate variability (HRV) during NREM sleep in patients having restless legs syndrome and periodic leg movements during sleep.

METHODS

The absolute and normalized high- and low-frequency peaks from spectral analysis (FFT) of R-R intervals, the HRV changes using wavelet transform, the geometric and time domain HRV were measured in 14 patients with restless legs syndrome and PLMS. The analysis was done comparing one hundred, 10 min periods with PLMS (PLMS+) and 60 periods without PLMS (PLMS-) in stage 2 of NREM sleep. In 8 patients analysis was also done in slow wave sleep (SWS).

RESULTS

Occurrence of PLMS induced changes in geometrical indices of HRV, with a rise of the triangular index and the triangular interpolation of R-R intervals in PLMS+ periods (P < 0.0001). Small changes in time domain indices were found during PLMS+ periods, while the SD of the R-R intervals (SDNN), reflecting global HRV, was significantly higher (P = 0.001). While the low frequency (LF) power significantly increased in PLMS+ periods (P < 0.0001), high frequency (HF) power showed a weak and not significant reduction. The rise in sympathetic activity as detected by frequency domain HRV analysis was related to density and interval of PLMS. Comparison between sleep stages of NREM sleep demonstrated lower values of HRV measures when PLMS+ periods occur in SWS.

CONCLUSIONS

Overall, PLMS occurrence was associated with a shift to increased sympathetic activity without significant changes in cardiac parasympathetic activity. The frequency domain analysis of HRV appears to be an easy tool to estimate the autonomic changes related to PLMS and PLMS- arousals and to differentiate their occurrence during stage 2 and deep sleep.

SIGNIFICANCE

Spectral HRV measures may offer a simple approach to estimate the degree of autonomic changes occurring in relation to periodic leg movements in restless legs patients.

Authors+Show Affiliations

Laboratoire de Sommeil, Service de Psychiatrie Adulte, Hôpitaux Universitaires de Genève, Switzerland. emilia.sforza@hcuge.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15826850

Citation

Sforza, Emilia, et al. "Cardiovascular Variability During Periodic Leg Movements: a Spectral Analysis Approach." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 116, no. 5, 2005, pp. 1096-104.
Sforza E, Pichot V, Barthelemy JC, et al. Cardiovascular variability during periodic leg movements: a spectral analysis approach. Clin Neurophysiol. 2005;116(5):1096-104.
Sforza, E., Pichot, V., Barthelemy, J. C., Haba-Rubio, J., & Roche, F. (2005). Cardiovascular variability during periodic leg movements: a spectral analysis approach. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 116(5), 1096-104.
Sforza E, et al. Cardiovascular Variability During Periodic Leg Movements: a Spectral Analysis Approach. Clin Neurophysiol. 2005;116(5):1096-104. PubMed PMID: 15826850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular variability during periodic leg movements: a spectral analysis approach. AU - Sforza,Emilia, AU - Pichot,Vincent, AU - Barthelemy,Jean Claude, AU - Haba-Rubio,José, AU - Roche,Frederic, PY - 2004/07/09/received PY - 2004/12/19/revised PY - 2004/12/31/accepted PY - 2005/4/14/pubmed PY - 2005/6/9/medline PY - 2005/4/14/entrez SP - 1096 EP - 104 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 116 IS - 5 N2 - OBJECTIVE: Changes in cardiovascular measures have been advocated as sensitive markers of phasic events arising from sleep. The current study was aimed to analyse the effects of periodic leg movements (PLMS) on heart rate variability (HRV) during NREM sleep in patients having restless legs syndrome and periodic leg movements during sleep. METHODS: The absolute and normalized high- and low-frequency peaks from spectral analysis (FFT) of R-R intervals, the HRV changes using wavelet transform, the geometric and time domain HRV were measured in 14 patients with restless legs syndrome and PLMS. The analysis was done comparing one hundred, 10 min periods with PLMS (PLMS+) and 60 periods without PLMS (PLMS-) in stage 2 of NREM sleep. In 8 patients analysis was also done in slow wave sleep (SWS). RESULTS: Occurrence of PLMS induced changes in geometrical indices of HRV, with a rise of the triangular index and the triangular interpolation of R-R intervals in PLMS+ periods (P < 0.0001). Small changes in time domain indices were found during PLMS+ periods, while the SD of the R-R intervals (SDNN), reflecting global HRV, was significantly higher (P = 0.001). While the low frequency (LF) power significantly increased in PLMS+ periods (P < 0.0001), high frequency (HF) power showed a weak and not significant reduction. The rise in sympathetic activity as detected by frequency domain HRV analysis was related to density and interval of PLMS. Comparison between sleep stages of NREM sleep demonstrated lower values of HRV measures when PLMS+ periods occur in SWS. CONCLUSIONS: Overall, PLMS occurrence was associated with a shift to increased sympathetic activity without significant changes in cardiac parasympathetic activity. The frequency domain analysis of HRV appears to be an easy tool to estimate the autonomic changes related to PLMS and PLMS- arousals and to differentiate their occurrence during stage 2 and deep sleep. SIGNIFICANCE: Spectral HRV measures may offer a simple approach to estimate the degree of autonomic changes occurring in relation to periodic leg movements in restless legs patients. SN - 1388-2457 UR - https://www.unboundmedicine.com/medline/citation/15826850/Cardiovascular_variability_during_periodic_leg_movements:_a_spectral_analysis_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1388-2457(05)00005-2 DB - PRIME DP - Unbound Medicine ER -