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Sleep-related autonomic overactivity in a general elderly population and its relationship to cardiovascular regulation

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Abstract

Alteration in cardiac autonomic activity during sleep is a common feature of sleep disorders. Diurnal sympathetic overactivity is a possible consequence and could contribute to future cardiovascular complications. The aim of this study is to assess the relationship between cardiac autonomic activity during sleep and diurnal autonomic cardiovascular control. In a large cohort (n = 1011) of subjects aged 65 years old (±0.4) free of cardiac and cerebrovascular events and of sleep-related breathing disorders, we evaluated (cross-sectional study) the prevalence of unexpected alteration in sleep-related autonomic overactivity according to the presence of a cyclical nocturnal heart rate variability [quantified using the relative power spectral density of the very low-frequency band of the heart rate increment (VLFi %) from ECG Holter monitoring]. We tested its relationship with diurnal ambulatory blood pressure and spontaneous baroreflex sensitivity (sBRS). An abnormal cardiac autonomic activity during sleep was retained in 34.4 % of this population according to a VLFi % >4. Using multiple logistic regression analysis, the severity of the autonomic alteration was mainly correlated after adjustment with lower sBRS (p = 0.01; OR: 0.94; 95 % CI: 0.90–0.98). Diurnal baroreflex control alteration is associated with sleep-related autonomic overactivity elderly. Such alteration may contribute to the increased incidence of cardiovascular complications in sleep disorders.

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References

  1. Chouchou F, Pichot V, Barthélémy JC, Bastuji H, Roche F (2014) Cardiac sympathetic modulation in response to apneas/hypopneas through heart rate variability analysis. PLoS One 22:e86434

    Article  Google Scholar 

  2. Sforza E, Pichot V, Barthelemy JC, Haba-Rubio J, Roche F (2005) Cardiovascular variability during periodic leg movements: a spectral analysis approach. Clin Neurophysiol 116:1096–1104

    Article  PubMed  Google Scholar 

  3. Chouchou F, Pichot V, Perchet C, Legrain V, Garcia-Larrea L, Roche F, Bastuji H (2011) Autonomic pain responses during sleep: a study of heart rate variability. Eur J Pain 15:554–560

    Article  PubMed  CAS  Google Scholar 

  4. Nashed A, Lanfranchi P, Rompré P, Carra MC, Mayer P, Colombo R, Huynh N, Lavigne G (2012) Sleep bruxism is associated with a rise in arterial blood pressure. Sleep 35:529–536

    PubMed  PubMed Central  Google Scholar 

  5. Blasi A, Jo J, Valladares E, Morgan BJ, Skatrud JB, Khoo M (2003) Cardiovascular variability after arousal from sleep: time-varying spectral analysis. J Appl Physiol 95:1394–1404

    Article  PubMed  Google Scholar 

  6. Roche F, Court-Fortune I, Pichot V, Duverney D, Costes F, Emonot A, Vergnon JM, Geyssant A, Lacour JR, Barthélémy JC (1999) Reduced cardiac sympathetic autonomic tone after long-term nasal continuous positive airway pressure in obstructive sleep apnoea syndrome. Clin Physiol 19:127–134

    Article  PubMed  CAS  Google Scholar 

  7. Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, Stubbs R, Hla KM (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31:1071–1078

    PubMed  PubMed Central  Google Scholar 

  8. Haralabidis AS, Dimakopoulou K, Vigna-Taglianti F, Giampaolo M, Borgini A, Dudley ML, Pershagen G, Bluhm G, Houthuijs D, Babisch W, Velonakis M, Katsouyanni K, Jarup L; HYENA Consortium (2008) Acute effects of night-time noise exposure on blood pressure in populations living near airports. Eur Heart J 29:658–664

    Article  Google Scholar 

  9. Roche F, Duverney D, Court-Fortune I, Pichot V, Costes F, Lacour JR, Antoniadis JA, Gaspoz JM, Barthelemy JC (2002) Cardiac interbeat interval increment for the identification of obstructive sleep apnea. Pacing Clin Electrophysiol 25:1192–1199

    Article  PubMed  Google Scholar 

  10. Roche F, Celle S, Pichot V, Barthélémy JC, Sforza E (2007) Analysis of the interbeat interval increment to detect obstructive sleep apnoea/hypopnoea. Eur Respir J 29:1206–1211

    Article  PubMed  CAS  Google Scholar 

  11. Roche F, Sforza E, Duverney D, Borderies JR, Pichot V, Bigaignon O, Ascher G, Barthélémy JC (2004) Heart rate increment: an electrocardiological approach for the early detection of obstructive sleep apnoea/hypopnoea syndrome. Clin Sci (Lond) 107:105–110

    Article  Google Scholar 

  12. Damy T, D’Ortho MP, Estrugo B, Margarit L, Mouillet G, Mahfoud M, Roudot-Thoraval F, Vermes E, Hittinger L, Roche F, Macquin-Mavier I (2010) Heart rate increment analysis is not effective for sleep-disordered breathing screening in patients with chronic heart failure. J Sleep Res 19:131–138

    Article  PubMed  Google Scholar 

  13. Sforza E, Chouchou F, Pichot V, Barthélémy JC, Roche F (2012) Heart rate increment in the diagnosis of obstructive sleep apnoea in an older population. Sleep Med 13:21–28

    Article  PubMed  Google Scholar 

  14. Sforza E, Pichot V, Cervena K, Barthélémy JC, Roche F (2007) Cardiac variability and heart-rate increment as a marker of sleep fragmentation in patients with a sleep disorder: a preliminary study. Sleep 30:43–51

    PubMed  Google Scholar 

  15. Dauphinot V, Barthélémy JC, Pichot V, Celle S, Sforza E, Achour-Crawford E, Gosse P, Roche F (2012) Autonomic activation during sleep and new-onset ambulatory hypertension in the elderly. Int J Cardiol 155:155–159

    Article  PubMed  Google Scholar 

  16. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, D’Agostino RB, Newman AB, Lebowitz MD, Pickering TG (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep heart health study. JAMA 283:1829–1836

    Article  PubMed  CAS  Google Scholar 

  17. Barthelemy JC, Pichot V, Dauphinot V, Celle S, Laurent B, Garcin A, Maudoux D, Kerleroux J, Lacour JR, Kossovsky M, Gaspoz JM, Roche F (2007) Autonomic nervous system activity and decline as prognostic indicators of cardiovascular and cerebrovascular events: the ‘PROOF’ Study. Study design and population sample. Associations with sleep-related breathing disorders: the ‘SYNAPSE’ study. Neuroepidemiology 29:18–28

    Article  PubMed  Google Scholar 

  18. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545

    PubMed  CAS  Google Scholar 

  19. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, Jones DW, Kurtz T, Sheps SG, Roccella EJ, Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research (2005) Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 45:142–161

    Article  PubMed  CAS  Google Scholar 

  20. Merri M, Farden DC, Mottley JG, Titlebaum EL (1990) Sampling frequency of the electrocardiogram for spectral analysis of the heart rate variability. IEEE Trans Biomed Eng 37:99–106

    Article  PubMed  CAS  Google Scholar 

  21. Mancia G, Casadel R, Mutti E, Trazzi S, Parati G (1989) Ambulatory blood pressure monitoring in the evaluation of antihypertensive treatment. Am J Med 87:64S–69S

    Article  PubMed  CAS  Google Scholar 

  22. Parlow J, Viale JP, Annat G, Hughson R, Quintin L (1995) Spontaneous cardiac baroreflex in humans. Comparison with drug-induced responses. Hypertension 25:1058–1068

    Article  PubMed  CAS  Google Scholar 

  23. Chouchou F, Pichot V, Pepin JL, Tamisier R, Celle S, Maudoux D, Garcin A, Lévy P, Barthélémy JC, Roche F, PROOF Study Group (2013) Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J 34:2122–2131

    Article  PubMed  CAS  Google Scholar 

  24. Francis DP, Davies LC, Willson K, Ponikowski P, Coats AJ, Piepoli M (2000) Very-low-frequency oscillations in heart rate and blood pressure in periodic breathing: role of the cardiovascular limb of the hypoxic chemoreflex. Clin Sci (Lond) 99:125–132

    Article  CAS  Google Scholar 

  25. Thayer JF, Yamamoto SS, Brosschot JF (2010) The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 141:122–131

    Article  PubMed  Google Scholar 

  26. Pepin JL, Tamisier R, Baguet JP, Levy P (2013) Arterial health is related to obstructive sleep apnea severity and improves with CPAP treatment. Sleep Med Rev 17:3–5

    Article  PubMed  Google Scholar 

  27. Chouchou F, Sforza E, Celle S, Pichot V, Maudoux D, Garcin A, Barthélémy JC, Roche F, PROOF Study Group (2011) Pulse transit time in screening sleep disordered breathing in an elderly population: the PROOF-SYNAPSE study. Sleep 34:1051–10592

    PubMed  PubMed Central  Google Scholar 

  28. Taylor JA, Carr DL, Myers CW, Eckberg DL (1998) Mechanisms underlying very-low-frequency RR-interval oscillations in humans. Circulation 98:547–555

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The PROOF-SYNAPSE research study group thanks the DRCI, Saint Etienne University Hospital, (France), and the “Association de Recherche SYNAPSE” for their support (PHRC National 1998). PHRC 1999 French Minister of Health, DRCI from Saint Etienne University Hospital, France.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Service de Gériatrie et Gérontologie, CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne PRES de Lyon, France

    Emilie Crawford-Achour

  2. Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l’Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France

    Frédéric Roche, Vincent Pichot, Sébastien Celle, Jean-Claude Barthélémy & Florian Chouchou

  3. CHU Nord, Niveau 6, EFCR, 42055, Saint-Etienne Cedex 2, France

    Frédéric Roche

Authors
  1. Emilie Crawford-Achour
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  2. Frédéric Roche
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  3. Vincent Pichot
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  4. Sébastien Celle
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  5. Jean-Claude Barthélémy
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  6. Florian Chouchou
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Corresponding author

Correspondence to Frédéric Roche.

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On the behalf of PROOF research study group.

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Crawford-Achour, E., Roche, F., Pichot, V. et al. Sleep-related autonomic overactivity in a general elderly population and its relationship to cardiovascular regulation. Heart Vessels 31, 46–51 (2016). https://doi.org/10.1007/s00380-014-0573-9

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  • DOI: https://doi.org/10.1007/s00380-014-0573-9

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