{Reference Type}: Journal Article
{Title}: Predominant cardiac sympathetic modulation during wake and sleep in patients with Rett syndrome.
{Author}: Rodrigues GD;Cordani R;Veneruso M;Chiarella L;Prato G;Ferri R;Carandina A;Tobaldini E;Nobili L;Montano N;
{Journal}: Sleep Med
{Volume}: 119
{Issue}: 0
{Year}: 2024 Jul 28
{Factor}: 4.842
{DOI}: 10.1016/j.sleep.2024.04.036
{Abstract}: <B>BACKGROUND: </B>Rett syndrome (RTT) is a rare neurological disorder primarily associated with mutations in the methyl-CpG-binding protein 2 (MECP2) gene. The syndrome is characterized by cognitive, social, and physical impairments, as well as sleep disorders and epilepsy. Notably, dysfunction of the autonomic nervous system is a key feature of the syndrome. Although Heart Rate Variability (HRV) has been used to investigate autonomic nervous system dysfunction in RTT during wakefulness, there is still a significant lack of information regarding the same during sleep. Therefore, our aim was to investigate cardiovascular autonomic modulation during sleep in subjects with RTT compared to an age-matched healthy control group (HC).<BR><B>METHODS: </B>A complete overnight polysomnographic (PSG) recording was obtained from 11 patients with Rett syndrome (all females, 10 ± 4 years old) and 11 HC (all females, 11 ± 4 years old; p = 0.48). Electrocardiogram and breathing data were extracted from PSG and divided into wake, non-REM, and REM sleep stages. Cardiac autonomic control was assessed using symbolic non-linear heart rate variability analysis. The symbolic analysis identified three patterns: 0 V% (sympathetic), 2UV%, and 2LV% (vagal).<BR><B>RESULTS: </B>The 0 V% was higher in the RTT group than in the HC group during wake, non-REM, and REM stages (p < 0.01), while the 2LV and 2UV% were lower during wake and sleep stages (p < 0.01). However, the 0 V% increased similarly from the wake to the REM stage in both RTT and HC groups.<BR><B>CONCLUSIONS: </B>Therefore, the sympatho-vagal balance shifted towards sympathetic predominance and vagal withdrawal during wake and sleep in RTT, although cardiac autonomic dynamics were preserved during sleep.