Cited by 1,574Heart Rate Variability and Autonomic ControlSleep and Wakefulness ResearchNeuroscience of respiration and sleep

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Sympathetic-Nerve Activity during Sleep in Normal Subjects

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Somers, Virend K., Dyken, Mark E., Mark, Allyn L., Abboud, Francois M.·1993·New England Journal of Medicine

DOI 10.1056/nejm199302043280502

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Abstract

BACKGROUND: The early hours of the morning after awakening are associated with an increased frequency of events such as myocardial infarction and ischemic stroke. The triggering mechanisms for these events are not clear. We investigated whether autonomic changes occurring during sleep, particularly rapid-eye-movement (REM) sleep, contribute to the initiation of such events. METHODS: We measured blood pressure, heart rate, and sympathetic-nerve activity (using microneurography, which provides direct measurements of efferent sympathetic-nerve activity related to muscle blood vessels) in eight normal subjects while they were awake and while in the five stages of sleep. RESULTS: The mean (+/- SE) amplitude of bursts of sympathetic-nerve activity and levels of blood pressure and heart rate declined significantly (P < 0.001), from 100 +/- 9 percent, 90 +/- 4 mm Hg, and 64 +/- 2 beats per minute, respectively, during wakefulness to 41 +/- 9 percent, 80 +/- 4 mm Hg, and 59 +/- 2 beats per minute, respectively, during stage 4 of non-REM sleep. Arousal stimuli during stage 2 sleep elicited high-amplitude deflections on the electroencephalogram (called K complexes), which were frequently associated with bursts of sympathetic-nerve activity and transient increases in blood pressure. During REM sleep, sympathetic-nerve activity increased significantly (to 215 +/- 11 percent; P < 0.001) and the blood pressure and heart rate returned to levels similar to those during wakefulness. Momentary restorations of muscle tone during REM sleep (REM twitches) were associated with cessation of sympathetic-nerve discharge and surges in blood pressure. CONCLUSIONS: REM sleep is associated with profound sympathetic activation in normal subjects, possibly linked to changes in muscle tone. The hemodynamic and sympathetic changes during REM sleep could play a part in triggering ischemic events in patients with vascular disease.

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A manual for standardized terminology, techniques and scoring system for sleep stages in human subjects
Rechtschaffen, A. (1968) · Medical Entomology and Zoology · Cited by 11,772
A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects.
Wolpert, E. (1969) · Archives of General Psychiatry · doi:10.1001/archpsyc.1969.01740140118016 · Cited by 9,850
Circadian Variation in the Frequency of Onset of Acute Myocardial Infarction
Muller, J. E., Stone, P. H., Turi, Z. G., Rutherford, J. D., Czeisler, C. A., Parker, C., Poole, W. K., Passamani, E., Roberts, R., Robertson, T., et al. (1985) · New England Journal of Medicine · doi:10.1056/nejm198511213132103 · Cited by 1,884
Cyclic variations in EEG during sleep and their relation to eye movements, body motility, and dreaming
Dement, W., & Kleitman, N. (1957) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(57)90088-3 · Cited by 1,876
Circadian variation and triggers of onset of acute cardiovascular disease.
Muller, J. E., Tofler, G. H., & Stone, P. H. (1989) · Circulation · doi:10.1161/01.cir.79.4.733 · Cited by 1,426
Reflex Regulation of Arterial Pressure during Sleep in Man
Smyth, H. S., Sleight, P., & Pickering, G. W. (1969) · Circulation Research · doi:10.1161/01.res.24.1.109 · Cited by 1,278
Circadian variation in the frequency of sudden cardiac death.
Muller, J. E., Ludmer, P. L., Willich, S. N., Tofler, G. H., Aylmer, G., Klangos, I., & Stone, P. H. (1987) · Circulation · doi:10.1161/01.cir.75.1.131 · Cited by 1,083
Concurrent Morning Increase in Platelet Aggregability and the Risk of Myocardial Infarction and Sudden Cardiac Death
Tofler, G. H., Brezinski, D., Schafer, A. I., Czeisler, C. A., Rutherford, J. D., Willich, S. N., Gleason, R. E., Williams, G. H., & Muller, J. E. (1987) · New England Journal of Medicine · doi:10.1056/nejm198706113162405 · Cited by 1,072
Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing.
Parati, G., Casadei, R., Groppelli, A., Di Rienzo, M., & Mancia, G. (1989) · Hypertension · doi:10.1161/01.hyp.13.6.647 · Cited by 899
Changes in autonomic regulation induced by physical training in mild hypertension.
Pagani, M., Somers, V. K., Furlan, R., Dell’Orto, S., Conway, J., Baselli, G., Cerutti, S., Sleight, P., & Malliani, A. (1988) · Hypertension · doi:10.1161/01.hyp.12.6.600 · Cited by 749
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Show all 35 references

Research works printed but not linked: 2

Wallin G. Intraneural recording and autonomic function in man. In: Bannister R, ed. Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. Oxford, England: Oxford University Press, 1983:36-51.
Snedecor GW, Cochran WG. Statistical methods. 7th ed. Ames: Iowa State University Press, 1980:265-7.

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Lin, C.-Y., Ho, C.-S., Tsai, W., & Chen, J. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.01.008 · Cited by 8
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Sayk, F., Twesten, C., Adametz, I., Franzen, K. F., Vonthein, R., Dodt, C., & Meusel, M. (2020) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00355.2019 · Cited by 8
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Woodward, S. H. (2022) · Neurobiology of Stress · doi:10.1016/j.ynstr.2022.100483 · Cited by 8
Control mechanism modeling of human cardiovascular-respiratory system
Gutta, S., Cheng, Q., & Benjamin, B. (2015) · IEEE Global Conference on Signal and Information Processing · doi:10.1109/globalsip.2015.7418331 · Cited by 8
Hypoglossal nerve stimulation therapy on peripheral arterial tonometry in obstructive sleep apnea: a pilot study
Ikeda, A. K., Li, Q., Quyuumi, A. A., & Dedhia, R. C. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1676-9 · Cited by 8
Alterations in the Sympathetic and Parasympathetic Nervous Systems in Heart Failure
Floras, J. S. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-5895-3.10016-6 · Cited by 8
Cardiovascular issues in obstructive sleep apnoea in children: A brief review
Gallucci, M., Gessaroli, M., Bronzetti, G., di Palmo, E., Bertelli, L., Giannetti, A., & Ricci, G. (2020) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2020.05.007 · Cited by 8
Impact of intermittent hypoxia on human vascular responses during sleep
Beaudin, A. E., Hanly, P. J., Raneri, J. K., Younes, M. K., Pun, M., Anderson, T. J., & Poulin, M. J. (2021) · Experimental Neurology · doi:10.1016/j.expneurol.2021.113897 · Cited by 8
Physiology of the Cardiovascular, Endocrine and Renal Systems during Sleep
Peter, J. G., & Fietze, I. (2006) · KARGER eBooks · doi:10.1159/000093140 · Cited by 8
Chapter 2 NREM–REM sleep
Rama, A. N., Cho, S. C., & Kushida, C. A. (2005) · Handbook of clinical neurophysiology · doi:10.1016/s1567-4231(09)70027-9 · Cited by 8
Clinic blood pressure, ambulatory blood pressure and cardiac structural alterations in nonagenarians and in centenarians
Carugo, S., Solari, D., Esposito, A. A., Pernigotti, A., Caimi, B., Redaelli, C., Maisaidi, M., Brambilla, G., Grassi, G. M., & Mancia, G. (2011) · Blood Pressure · doi:10.3109/08037051.2012.641266 · Cited by 8
Autonomic Function and QT Interval During Night-Time Sleep in Infant Long QT Syndrome
Yoshinaga, M., Kucho, Y., Ushinohama, H., Ishikawa, Y., Ohno, S., & Ogata, H. (2018) · Circulation Journal · doi:10.1253/circj.cj-18-0048 · Cited by 8
Copine-7 is required for REM sleep regulation following cage change or water immersion and restraint stress in mice
Liu, C.-Y., Tsai, C. Y., Yasugaki, S., Nagata, N., Morita, M., Isotani, A., Yanagisawa, M., & Hayashi, Y. (2020) · Neuroscience Research · doi:10.1016/j.neures.2020.04.002 · Cited by 8
Association of obstructive sleep apnea with homocystein, nitric oxide and total antioxidant capacity levels in patients with or without coronary artery disease
Ersoy, E. O., Fırat, H., Yardım-Akaydin, S., Özkan, Y., Durusu, M., Yüce, G. D., Ergün, R., Topeli̇, A., & Ardıç, S. (2014) · Tuberkuloz ve Toraks · doi:10.5578/tt.7845 · Cited by 8
Cerebral Doppler Sonography of the Neonate: A Résumé After 20 Years and Future Aspects
Ipsiroglu, O., Eichler, F., & Stoeckler-Ipsiroglu, S. (1999) · Clinics in Perinatology · doi:10.1016/s0095-5108(18)30027-7 · Cited by 8
Therapeutic Application of Transcutaneous Auricular Vagus Nerve Stimulation in Primary Insomnia
Yoon, H. (2019) · Chronobiology in Medicine · doi:10.33069/cim.2019.0011 · Cited by 7
Effect of Extended-Release Isosorbide Mononitrate One Hour After Dosing in Patients With Stable Angina Pectoris fn1fn1This study was supported by a grant from the Schering Corporation, Kenilworth, New Jersey.
Glasser, S. P. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00802-3 · Cited by 8
Sleep, Blood Pressure Regulation, and Hypertension
Caples, S. M., & Somers, V. K. (2007) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2006.12.005 · Cited by 8
Self-citation
Sodium, Potassium, the Sympathetic Nervous System, and the Renin—Angiotensin System
Sica, D. A., & Wilson, D. K. (2001) · Humana Press eBooks · doi:10.1007/978-1-59259-004-9_8 · Cited by 8
The determinants of long-term blood pressure stability
Dickinson, C. J. (1998) · Journal of Hypertension · doi:10.1097/00004872-199816070-00002 · Cited by 8
Neuropeptide changes in the suprachiasmatic nucleus in primary hypertension indicate functional impairment of the biological clock
Goncharuk (2001) · Pure Amsterdam UMC · doi:10.1002/1096-9861(20010312)431:3
Autoradiographic and in situ hybridization localization of corticotropin-releasing factor 1 and 2 receptors in nonhuman primate brain
S�nchez, M. M., Young, L. J., Plotsky, P. M., & Insel, T. R. (1999) · The Journal of Comparative Neurology · doi:10.1002/(sici)1096-9861(19990607)408:3

Authors: Somers, V. K., Dyken, M. E., Mark, A. L., & Abboud, F. M.
Affiliations: University of Iowa (US)
ORCID: Somers, Virend K.
Dyken, Mark E.
Mark, Allyn L.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1993-02-04
Volume: 328
Issue: 5
Pages: 303-307
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm199302043280502
OpenAlex: W2316139099
Cited by: 1,574
References: 35
Citations by year: 2026: 43 · 2025: 67 · 2024: 68 · 2023: 56 · 2022: 68 · 2021: 75 · 2020: 58 · 2019: 70 · 2018: 64 · 2017: 57 · 2016: 53 · 2015: 56 · 2014: 57 · 2013: 44 · 2012: 63
FWCI: 25.34
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (HL-24962, HL-14388, P01HL014388)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords: sympathetic activity, REM sleep, NREM sleep, blood pressure, heart rate, K-complexes, muscle tone, autonomic nervous system, sleep arousal, myocardial infarction, ischemic stroke
MeSH terms: Adult, Blood Pressure, Blood Vessels, Electrocardiography, Female, Heart Rate, Humans, Male, Nitroprusside, Sleep, Sleep Stages, Sleep, REM, Sympathetic Nervous System, Wakefulness

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Sympathetic-Nerve Activity during Sleep in Normal Subjects

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