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J Clin Sleep Med. 2019 Nov 27. pii: jc-19-00271. [Epub ahead of print]
Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome.
Fatt SJ1, Beilharz JE1, Joubert M1, Wilson C1, Lloyd AR2, Vollmer-Conna U1, Cvejic E1,3.
Author information
1School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia.
2Viral Immunology Systems Program, The Kirby Institute, University of New South Wales Sydney, New South Wales, Australia.
3The University of Sydney, School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.
Abstract
STUDY OBJECTIVES:
Physiological dearousal characterized by an increase in parasympathetic nervous system activity is important for good-quality sleep. Previous research shows that nocturnal parasympathetic activity (reflected by heart rate variability [HRV]) is diminished in individuals with chronic fatigue syndrome (CFS), suggesting hypervigilant sleep. This study investigated differences in nocturnal autonomic activity across sleep stages and explored the association of parasympathetic activity with sleep quality and self-reported physical and psychological wellbeing in individuals with CFS.
METHODS:
Twenty-four patients with medically diagnosed CFS, and 24 matched healthy control individuals participated. Electroencephalography and HRV were recorded during sleep in participants' homes using a minimally invasive ambulatory device. Questionnaires were used to measure self-reported wellbeing and sleep quality.
RESULTS:
Sleep architecture in patients with CFS differed from that of control participants in slower sleep onset, more awakenings, and a larger proportion of time spent in slow-wave sleep (SWS). Linear mixed-model analyses controlling for age revealed that HRV reflecting parasympathetic activity (normalized high frequency power) was reduced in patients with CFS compared to control participants, particularly during deeper stages of sleep. Poorer self-reported wellbeing and sleep quality was associated with reduced parasympathetic signaling during deeper sleep, but not during wake before sleep, rapid eye movement sleep, or with the proportion of time spent in SWS.
CONCLUSIONS:
Autonomic hypervigilance during the deeper, recuperative stages of sleep is associated with poor quality sleep and self-reported wellbeing. Causal links need to be confirmed but provide potential intervention opportunities for the core symptom of unrefreshing sleep in CFS.
© 2019 American Academy of Sleep Medicine.
Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome.
Fatt SJ1, Beilharz JE1, Joubert M1, Wilson C1, Lloyd AR2, Vollmer-Conna U1, Cvejic E1,3.
Author information
1School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia.
2Viral Immunology Systems Program, The Kirby Institute, University of New South Wales Sydney, New South Wales, Australia.
3The University of Sydney, School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.
Abstract
STUDY OBJECTIVES:
Physiological dearousal characterized by an increase in parasympathetic nervous system activity is important for good-quality sleep. Previous research shows that nocturnal parasympathetic activity (reflected by heart rate variability [HRV]) is diminished in individuals with chronic fatigue syndrome (CFS), suggesting hypervigilant sleep. This study investigated differences in nocturnal autonomic activity across sleep stages and explored the association of parasympathetic activity with sleep quality and self-reported physical and psychological wellbeing in individuals with CFS.
METHODS:
Twenty-four patients with medically diagnosed CFS, and 24 matched healthy control individuals participated. Electroencephalography and HRV were recorded during sleep in participants' homes using a minimally invasive ambulatory device. Questionnaires were used to measure self-reported wellbeing and sleep quality.
RESULTS:
Sleep architecture in patients with CFS differed from that of control participants in slower sleep onset, more awakenings, and a larger proportion of time spent in slow-wave sleep (SWS). Linear mixed-model analyses controlling for age revealed that HRV reflecting parasympathetic activity (normalized high frequency power) was reduced in patients with CFS compared to control participants, particularly during deeper stages of sleep. Poorer self-reported wellbeing and sleep quality was associated with reduced parasympathetic signaling during deeper sleep, but not during wake before sleep, rapid eye movement sleep, or with the proportion of time spent in SWS.
CONCLUSIONS:
Autonomic hypervigilance during the deeper, recuperative stages of sleep is associated with poor quality sleep and self-reported wellbeing. Causal links need to be confirmed but provide potential intervention opportunities for the core symptom of unrefreshing sleep in CFS.
© 2019 American Academy of Sleep Medicine.
