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open access

Vol 58, No 2 (2024)
Research Paper
Submitted: 2023-04-11
Accepted: 2023-07-05
Published online: 2023-09-05
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Effect of series of periodic limb movements in sleep on blood pressure, heart rate and high frequency heart rate variability

Marta A. Malkiewicz1, Malgorzata Grzywinska2, Krzysztof S. Malinowski3, Eemil Partinen45, Markku Partinen46, Wieslaw J. Cubala7, Pawel J. Winklewski3, Mariusz Sieminski8
DOI: 10.5603/pjnns.95117
·
Pubmed: 37668022
·
Neurol Neurochir Pol 2024;58(2):167-175.
Affiliations
  1. Applied Cognitive Neuroscience Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdansk, Gdansk, Poland
  2. Neuroinformatics and Artificial Intelligence Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdansk, Gdansk, Poland
  3. Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdansk, Gdansk, Poland
  4. Helsinki Sleep Clinic, Terveystalo Healthcare, Helsinki, Finland
  5. Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
  6. Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
  7. Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland
  8. Department of Emergency Medicine, Medical University of Gdansk, Marii Sklodowskiej-Curie 3a, 80-210 Gdansk, Poland

open access

Vol 58, No 2 (2024)
Research papers
Submitted: 2023-04-11
Accepted: 2023-07-05
Published online: 2023-09-05

Abstract

Introduction. The phenomenon known as periodic limb movements in sleep (PLMS) has been linked to a change in autonomic nervous system (ANS) activity and its effect on circulatory regulation. Autonomic dysfunction or dysregulation in patients with PLMS has been described in some domains; however, any relationship between heart rate variability (HRV) and PLMS has not been clearly established. HRV analysis is a recognised, non-invasive research method that describes the influence of the ANS on heart rate (HR). The aim of our study was to further investigate the dysregulation of autonomic HR control in patients with PLMS.

Material and methods. We undertook a retrospective analysis of the polysomnographic (PSG), demographic and medical data of five patients with a total number of 1,348 PLMS. We analysed HR, HRV HF, systolic blood pressure (SBP), and diastolic blood pressure (DBP) for 10 heartbeats before the series of PLMS and 10 consecutive heartbeats as beat-to-beat measurements. The presented method of using successive, short, 10 RR interval segments refers to the time-frequency measurement, which is very clear and useful for presenting changes in the calculated parameters over time and thereby illustrating their dynamics. This method allowed us to assess dynamic changes in HRV HF during successive PLMS series. Statistical analysis was performed using IBM SPSS Statistics (v. 28.0.0.0). The Kruskal–Wallis test was performed to find statistically significant changes from baseline.

Results. No statistically significant changes in HR, SBP, or DBP were found in our group, although an increase in the value of the HRV HF was noted, suggesting an increase in intracardiac parasympathetic activity during the subsequent series of PLMS.

Conclusions. Our study indicates an increase in parasympathetic activity during the appearance of successive PLMS, which, with the simultaneous lack of changes in HR, may suggest an increase in sympathetic activity, and therefore the appearance of so-called ‘autonomic co-activation’ resulting in the possibility of life-threatening cardiac events.

Clinical implications. Our findings add to the literature information regarding HRV in PLMS, and highlight the need for further studies to elucidate the effects of these conditions on the ANS, and on cardiovascular health.

Abstract

Introduction. The phenomenon known as periodic limb movements in sleep (PLMS) has been linked to a change in autonomic nervous system (ANS) activity and its effect on circulatory regulation. Autonomic dysfunction or dysregulation in patients with PLMS has been described in some domains; however, any relationship between heart rate variability (HRV) and PLMS has not been clearly established. HRV analysis is a recognised, non-invasive research method that describes the influence of the ANS on heart rate (HR). The aim of our study was to further investigate the dysregulation of autonomic HR control in patients with PLMS.

Material and methods. We undertook a retrospective analysis of the polysomnographic (PSG), demographic and medical data of five patients with a total number of 1,348 PLMS. We analysed HR, HRV HF, systolic blood pressure (SBP), and diastolic blood pressure (DBP) for 10 heartbeats before the series of PLMS and 10 consecutive heartbeats as beat-to-beat measurements. The presented method of using successive, short, 10 RR interval segments refers to the time-frequency measurement, which is very clear and useful for presenting changes in the calculated parameters over time and thereby illustrating their dynamics. This method allowed us to assess dynamic changes in HRV HF during successive PLMS series. Statistical analysis was performed using IBM SPSS Statistics (v. 28.0.0.0). The Kruskal–Wallis test was performed to find statistically significant changes from baseline.

Results. No statistically significant changes in HR, SBP, or DBP were found in our group, although an increase in the value of the HRV HF was noted, suggesting an increase in intracardiac parasympathetic activity during the subsequent series of PLMS.

Conclusions. Our study indicates an increase in parasympathetic activity during the appearance of successive PLMS, which, with the simultaneous lack of changes in HR, may suggest an increase in sympathetic activity, and therefore the appearance of so-called ‘autonomic co-activation’ resulting in the possibility of life-threatening cardiac events.

Clinical implications. Our findings add to the literature information regarding HRV in PLMS, and highlight the need for further studies to elucidate the effects of these conditions on the ANS, and on cardiovascular health.

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Keywords

periodic limb movements in sleep, periodic movement disorder of sleep, heart rate variability, autonomic nervous system, sleep-related movement disorder, autonomic co-activation

About this article
Title

Effect of series of periodic limb movements in sleep on blood pressure, heart rate and high frequency heart rate variability

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 58, No 2 (2024)

Article type

Research Paper

Pages

167-175

Published online

2023-09-05

Page views

496

Article views/downloads

330

DOI

10.5603/pjnns.95117

Pubmed

37668022

Bibliographic record

Neurol Neurochir Pol 2024;58(2):167-175.

Keywords

periodic limb movements in sleep
periodic movement disorder of sleep
heart rate variability
autonomic nervous system
sleep-related movement disorder
autonomic co-activation

Authors

Marta A. Malkiewicz
Malgorzata Grzywinska
Krzysztof S. Malinowski
Eemil Partinen
Markku Partinen
Wieslaw J. Cubala
Pawel J. Winklewski
Mariusz Sieminski

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