Abstract
We determined whether alterations in heart rate dynamics during sleep in patients
with chronic fatigue syndrome (CFS) differed from controls and/or correlated with
changes of sleepiness before and after a night in the sleep laboratory. We compared
beat-to-beat RR intervals (RRI) during nocturnal sleep, sleep structure, and subjective
scores on visual analog scale for sleepiness in 18 CFS patients with 19 healthy controls
aged 25–55 after excluding subjects with sleep disorders. A short-term fractal scaling
exponent (α1) of RRI dynamics, analyzed by the detrended fluctuation analysis (DFA) method, was
assessed after stratifying patients into those who reported more or less sleepiness
after the night's sleep (a.m. sleepier or a.m. less sleepy, respectively). Patients
in the a.m. sleepier group showed significantly (p < 0.05) higher fractal scaling index α1 during non-rapid eye movement (non-REM) sleep (Stages 1, 2, and 3 sleep) than healthy
controls, although standard polysomnographic measures did not differ between the groups.
The fractal scaling index α1 during non-REM sleep was significantly (p < 0.05) higher than that during awake periods after sleep onset for healthy controls
and patients in the a.m. less sleepy group, but did not differ between sleep stages
for patients in the a.m. sleepier group. For patients, changes in self-reported sleepiness
before and after the night correlated positively with the fractal scaling index α1 during non-REM sleep (p < 0.05). These results suggest that RRI dynamics or autonomic nervous system activity
during non-REM sleep might be associated with disrupted sleep in patients with CFS.
Keywords
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Article info
Publication history
Published online: March 18, 2013
Accepted:
February 18,
2013
Received in revised form:
January 29,
2013
Received:
September 25,
2012
Footnotes
☆Conflict of interest: Dr. Natelson has received research support from Forest Laboratories and is a consultant for Electrocore Medical.
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
