Abstract | STUDY OBJECTIVES: DESIGN: Prospective study with control group. METHODS: Patients with POTS (n = 36) and healthy subjects (n = 36) completed a detailed sleep log and actigraphy for 7 days. RESULTS: Compared with healthy subjects, POTS patients have more self-reported problems including days with restless sleep (53 ± 30% vs. 21 ± 20%; P<0.001) and tiredness (75 ± 23% vs. 39 ± 27%; P<0.001). Using actigraphy, POTS patients have lower sleep efficiency (73 ± 13% vs. 79 ± 6%; P = 0.01). Actigraphy determined sleep onset latency ( SOL) did not vary significantly in the two groups, but subjective SOL was higher in POTS patient (56 ± 66 min vs. 1 3 ± 9 min; P = 0.001). In POTS patients, there was a significant correlation between subjective complaints of tiredness and actigraphic sleep efficiency (Rs = -0.36; R(2) = 0.15; P = 0.01), significant correlations between actigraphic SOL and upright norepinephrine levels (P = 0.040), and between wake after sleep onset and standing heart rate (P = 0.02). CONCLUSIONS: POTS patients have more sleep-related symptoms and poor sleep efficiency. The pattern of subjective vs. objective SOL mismatch is suggestive of sleep-state misperception. High norepinephrine correlated with actigraphic SOL, and this activation of the stress system may contribute significantly to a hyperarousal state with consequent insomnia, poor mental and physical health in POTS patients.
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Authors | Kanika Bagai, Candy I Wakwe, Beth Malow, Bonnie K Black, Italo Biaggioni, Sachin Y Paranjape, Carlos Orozco, Satish R Raj |
Journal | Autonomic neuroscience : basic & clinical
(Auton Neurosci)
Vol. 177
Issue 2
Pg. 260-5
(Oct 2013)
ISSN: 1872-7484 [Electronic] Netherlands |
PMID | 23538032
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2013 Elsevier B.V. All rights reserved. |
Topics |
- Actigraphy
(methods)
- Adult
- Cohort Studies
- Female
- Humans
- Male
- Middle Aged
- Polysomnography
(methods)
- Postural Orthostatic Tachycardia Syndrome
(epidemiology, physiopathology)
- Prospective Studies
- Sleep Stages
(physiology)
- Sleep Wake Disorders
(diagnosis, epidemiology, physiopathology)
- Wrist
(physiology)
- Young Adult
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