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. 2013 Jun;176(1-2):85-90.
doi: 10.1016/j.autneu.2013.02.015. Epub 2013 Mar 15.

Heart Rate Variability During Sleep and Subsequent Sleepiness in Patients With Chronic Fatigue Syndrome

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Heart Rate Variability During Sleep and Subsequent Sleepiness in Patients With Chronic Fatigue Syndrome

Fumiharu Togo et al. Auton Neurosci. .
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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.

Conflict of interest statement

Conflict of interest: Dr. Natelson has received research support from Forest Laboratories and is a consultant for Electrocore Medical.


Figure 1
Figure 1
Mean and SD of RR interval (RRI) and fractal scaling index α1 of RRI during each sleep stage in healthy controls (white bars) and chronic fatigue syndrome (CFS) patients who were either less sleepy (grey bars) or sleepier (black bars) after polysomnography. Values are means±SE. DFA, detrended fluctuation analysis, Full, full length; W, wakefulness; A, arousal; S1, Stage 1 sleep; S2, Stage 2 sleep; S3, Stage 3 sleep; R, Stage REM sleep. *p < 0.05 relative to healthy controls; p < 0.05 relative to patients with a.m. less sleepy group.

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