Kanika Bagai1,2, Amanda C Peltier1,2, Beth A Malow2, André Diedrich1,3,4,5, Cyndya A Shibao1,3, Bonnie K Black1,3, Sachin Y Paranjape1,3, Carlos Orozco1, Italo Biaggioni1,3,6, David Robertson1,2,3,6, Satish R Raj1,3,6,7. 1. Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN. 2. Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN. 3. Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN. 4. Department of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN. 5. Biomedical Engineering, Vanderbilt University School of Medicine, Nashville, TN. 6. Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN. 7. Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, AB, Canada.
Abstract
STUDY OBJECTIVES: Patients with postural tachycardia syndrome (POTS) commonly complain of fatigue, unrefreshing sleep, daytime sleepiness, and diminished quality of life. The study objective was to assess objective sleep quality in POTS patients using overnight polysomnography. METHODS: We studied 16 patients with POTS and 15 healthy control subjects performing daytime autonomic functions tests and overnight polysomnography at the Vanderbilt Clinical Research Center. RESULTS: There were no significant differences in the objective sleep parameters including sleep efficiency, sleep onset latency, wake time after sleep onset, REM latency, percentage of time spent in N1, N2, N3, and REM sleep, arousal index, apnea-hypopnea index, or periodic leg movement index in POTS patients as compared with healthy control subjects. There were significant negative correlations between sleep efficiency and the change in HR from supine to stand (rs = -0.527; p = 0.036). CONCLUSIONS: POTS patients do not have significant differences in objective sleep parameters as compared to control subjects based on overnight polysomnograms. Activation of the sympathetic nervous system may contribute significantly to the hyper arousal state and worsening of subjective estimates of sleep quality as previously reported in POTS patients.
STUDY OBJECTIVES:Patients with postural tachycardia syndrome (POTS) commonly complain of fatigue, unrefreshing sleep, daytime sleepiness, and diminished quality of life. The study objective was to assess objective sleep quality in POTS patients using overnight polysomnography. METHODS: We studied 16 patients with POTS and 15 healthy control subjects performing daytime autonomic functions tests and overnight polysomnography at the Vanderbilt Clinical Research Center. RESULTS: There were no significant differences in the objective sleep parameters including sleep efficiency, sleep onset latency, wake time after sleep onset, REM latency, percentage of time spent in N1, N2, N3, and REM sleep, arousal index, apnea-hypopnea index, or periodic leg movement index in POTS patients as compared with healthy control subjects. There were significant negative correlations between sleep efficiency and the change in HR from supine to stand (rs = -0.527; p = 0.036). CONCLUSIONS: POTS patients do not have significant differences in objective sleep parameters as compared to control subjects based on overnight polysomnograms. Activation of the sympathetic nervous system may contribute significantly to the hyper arousal state and worsening of subjective estimates of sleep quality as previously reported in POTS patients.
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