Abstract
BackgroundSeveral reports have described that individual periodic leg movements during sleep (PLMS) activities are associated with autonomic nervous system activity occurring shortly before each PLMS activity. Nevertheless, no study has investigated dynamic changes of autonomic nervous system activity before the onset of PLMS. This study detected changes in heart rate variability (HRV) at the onset of the period with PLMS using complex demodulation method.MethodsThis study enrolled 14 patients diagnosed as having idiopathic PLMS disorder (PLMD). In periods with and without PLMS during sleep stage 2, HRV-related variables and the spectral power of fluctuation of a high frequency (HF) band (FHFB) were analyzed and compared. The changes of those parameters during transition from the period without PLMS to that with PLMS were explored.ResultsSpectral power in the low frequency (LF) band and very low frequency (VLF) band were higher in the period with PLMS. Additionally, the average frequency in FHFB was higher. The frequency in this band fluctuated during the period with PLMS with remarkable elevation of FHFB. Moreover, spectral powers in FHFB, LF, and VLF were remarkably elevated shortly before the beginning of the period with PLMS (FHFB, -65 s; LF, -53 s; and VLF, -45 s).ConclusionsElevation of sympathetic nervous system activity and mean frequency fluctuation in an HF band can occur several tens of seconds before the period with PLMS. Dynamic changes in the autonomic nervous system activity might be related to the vulnerability to PLMS occurrence during the night.
Highlights
Several reports have described that individual periodic leg movements during sleep (PLMS) activities are associated with autonomic nervous system activity occurring shortly before each PLMS activity
This study was conducted to explore the changes in heart rate variability (HRV) in transition from the period in which PLMS are absent to the period with frequent PLMS using timefrequency domain analysis, and complex demodulation method, which has high temporal resolution to delineate time-dependent fluctuations in both the amplitude and frequency of non-stationary and long-period data [17,18]
The inclusion criteria applied to patients were the following: 1) diagnosed as idiopathic PLMS disorder (PLMD) according to the International Classification of Sleep Disorders Second Edition [19]; 2) apnea–hypopnea index < 5/hr; 3) absence of any pathological arrhythmia; 4) absence of any muscular or neurologic disease; and 5) not taking medication that might affect autonomic nervous system activity (Table 1)
Summary
Several reports have described that individual periodic leg movements during sleep (PLMS) activities are associated with autonomic nervous system activity occurring shortly before each PLMS activity. No study has investigated dynamic changes of autonomic nervous system activity before the onset of PLMS. This study detected changes in heart rate variability (HRV) at the onset of the period with PLMS using complex demodulation method. This study was conducted to explore the changes in HRV in transition from the period in which PLMS are absent to the period with frequent PLMS using timefrequency domain analysis, and complex demodulation method, which has high temporal resolution to delineate time-dependent fluctuations in both the amplitude and frequency of non-stationary and long-period data [17,18]
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