The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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Autonomic Nervous System Functioning Related to Nocturnal Sleep in Patients With Chronic Fatigue Syn

Discussion in 'Latest ME/CFS Research' started by Murph, Dec 19, 2017.

  1. Murph

    Murph :)

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    J Clin Sleep Med. 2017 Dec 13. pii: jc-17-00330. [Epub ahead of print]
    Autonomic Nervous System Functioning Related to Nocturnal Sleep in Patients With Chronic Fatigue Syndrome Compared to Tired Controls.
    Orjatsalo M, Alakuijala A, Partinen M.
    Abstract
    STUDY OBJECTIVES:
    Autonomic nervous system (ANS) dysfunction is common in chronic fatigue syndrome (CFS). One of the main complaints in CFS is unrefreshing sleep. We aimed to study the nocturnal cardiac ANS in different sleep stages in patients filling the 2015 Institute of Medicine CFS diagnostic criteria.

    METHODS:
    In this case series study, the nocturnal heart rate variability and blood pressure (BP) variables in polysomnography were studied in groups of patients with CFS (n = 8) and tired controls (n = 8) aged 16-49 years. Five of the patients with CFS and controls were female. The heart rate variability and BP parameters and heart rate were studied in all sleep stages and wake.

    RESULTS:
    The amount of low-frequency oscillations of the electrocardiography R-R-intervals spectra (LF; predominantly reflects sympathetic activity) was higher for patients with CFS in all sleep stages compared to controls (P< .001). During wake, the amount of LF was lower for the patients with CFS (P< .05). The amount of high-frequency oscillations (HF; reflects parasympathetic activity) was lower in stage N3 sleep in the patients with CFS than for the controls (P< .0001), but, in total, HF was higher in patients with CFS (P< .001). Patients with CFS had higher overall nocturnal systolic and mean BP (P< .0001) and lower heart rate (P< .0001) than controls. No significant differences were found in sleep stage distributions.

    CONCLUSIONS:
    The results suggest a nocturnal dysfunction of the cardiac ANS in CFS, presenting as lower parasympathetic tone in deep sleep and higher sympathetic tone asleep.

    KEYWORDS:
    autonomic nervous system; blood pressure; chronic fatigue syndrome; dysautonomia; heart rate variability; polysomnography; sleep; systemic exertion intolerance disease

    PMID:
    29246267
     
  2. Murph

    Murph :)

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    Good research topic to try to answer but Big question marks over effect sizes given how puny the sample size is. 8 patients? kind of a shame.

    p values look okay but with only 8 patients and 8 controls ~\_(",)_/~
     
    Ema likes this.
  3. Sad Dad

    Sad Dad

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    And, of those 8 patients, 1/2 were male, which is not representative of the CFS population, AND the age range was 16-49!
     
    BadBadBear likes this.
  4. BadBadBear

    BadBadBear Senior Member

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    Rocky Mountains
    I ran my HRV overnight a few times to see what it was doing, but it is rather futile as it is so difficult to find baseline HRV data to compare with.

    If anyone on PR has Elite HRV we could certainly attempt our own little study. :)
     
    echobravo likes this.
  5. anciendaze

    anciendaze Senior Member

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    Then again, compare this number with the number of patients in PACE who showed a substantial response to GET, let alone the number responding to GET+CBT (zero). There was deliberate misrepresentation of the number of patients subject to that intervention, and the number who responded by objective measurements. The fact that patients who felt worse could simply decline to participate in the walk test was also downplayed, as was the fact that performance of patients in the GET arm of the study remained grouped with patients in other studies having advanced heart failure -- after "successful" treatment.

    Yes, this is a small study. One good aspect is that it is much harder to hide things the authors don't want to show.

    What a wide range of studies have shown is that some patients given the vague label of "CFS" demonstrate problems standard clinical practice is ignoring. At some point we need to ask those responsible for treatment decisions if they think harming these patients is acceptable because someone else might benefit from an intervention that they do not. What number of excess deaths or incorrect commitals for mental illness would these authorities accept?
     
  6. echobravo

    echobravo Keep searching, the answer is out there

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    Norway
    I’m in!

    PS! The lowered parasympathic tone during sleep does not surprise me, dysautonomia seems to be central in ME - at least “my kind of ME”;)
     
    Last edited: Dec 19, 2017
    BadBadBear and Diwi9 like this.
  7. *GG*

    *GG* senior member

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    Concord, NH
    Diagnosed people, it is often said that lots of men probably just "ignore" their issues, so don't get a diagnosis.

    GG
     
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  8. unto

    unto Senior Member

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    there is someone in PR who knows in which situations (such as stress, infections, diseases ...)
    do these variations occur? it would be interesting to know
     

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