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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Self-citation

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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