期刊
SLEEP
卷 39, 期 3, 页码 565-571出版社
OXFORD UNIV PRESS INC
DOI: 10.5665/sleep.5528
关键词
baroreflex; sleep; heart rate variability; restless legs syndrome; periodic leg movements of sleep
资金
- Schwarz Pharma Ltd.
- NIH [K23AT005104]
- Harvard Catalyst \ The Harvard Clinical and Translational Science Center (National Center for Research Resources
- National Center for Advancing Translational Sciences, National Institutes of Health [UL1 TR001102]
- Harvard University
- UCB/Schwarz Pharma
- GlaxoSmithKline
- Impax Pharmaceuticals
Study Objectives: To examine whether patients with restless legs syndrome demonstrate specific alterations in cardiovascular autonomic control. Methods: Patients with moderate-severe restless legs syndrome (n = 20, 80% female) and controls (n = 20) matched for age, sex, body mass index, and free of hypertension and cardiovascular disease were enrolled. We assessed cardiovagal baroreflex gain via the modified Oxford technique, sympathetically mediated vascular responses to isometric exercise to fatigue, bradycardiac response to Valsalva maneuver, and respiratory sinus arrhythmia during paced breathing. Standard electrocardiography, beat-by-beat arterial pressure, respiration, and popliteal blood flow velocity were recorded continuously. Results: Resting blood pressure and heart rate were similar between groups. However, baroreflex gain averaged 14.3 +/- 1.4 msec/mm Hg in restless legs syndrome and was lower than in controls (22.6 +/- 3.5 msec/mm Hg, P = 0.04). Hemodynamic responses to isometric exercise were similar between groups, though participants with restless legs syndrome had lower leg blood flow (P < 0.001), with greater leg vascular resistance (P < 0.0001), before and during isometric exercise. Respiratory sinus arrhythmia and Valsalva ratios were similar between groups. Neither baroreflex gain nor vascular resistance was correlated with sleep duration, sleep quality, or symptom duration. Conclusion: Patients with restless legs syndrome demonstrate compromised cardiovagal control, specific to the arterial baroreflex, with greater peripheral vascular resistance, potentially due to heightened sympathetic outflow. These autonomic alterations may directly relate to the higher prevalence of cardiovascular disease in restless legs syndrome.
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