Key result
Bilateral carotid body tumor resection was associated with significantly lower low-frequency power of heart rate variability during active wakefulness, sleep stage 1, and REM sleep versus controls.
Why the study?
Does bilateral carotid body tumor resection affect sleep-mediated heart rate variability compared to matched controls?
Case-Control (n=18)
Does bilateral carotid body tumor resection affect sleep-mediated heart rate variability compared to matched controls?
Bilateral carotid body tumor resection decreases low frequency power during sleep, but overall sleep-related heart rate changes remain similar to controls, suggesting central pathways predominantly mediate these changes.
Bilateral resection-associated LF-HRV reductions during sleep stages warrant no practice change; leaves open predominant central mediation of autonomic control.
STUDY OBJECTIVES: The carotid bodies are thought to play an important role in sleep-dependent autonomic changes. Patients who underwent resection of bilateral carotid body tumors have chronically attenuated baroreflex sensitivity. These subjects provide a unique opportunity to investigate the role of the baroreflex during sleep. DESIGN: One-night ambulatory polysomnography (PSG) recording. SETTING: Participants' homes. PARTICIPANTS: Nine patients with bilateral carotid body tumor resection (bCBR) (four women, mean age 50.4 ± 7.2 years) and nine controls matched for age, gender, and body mass index. INTERVENTIONS: N/A. MEASUREMENTS: Sleep parameters were obtained from PSG. Heart rate (HR) and its variability were calculated using 30-s epochs. RESULTS: In bCBR patients, HR was slightly but not significantly increased during wake and all sleep stages. The effect of sleep on HR was similar for patients and controls. Low frequency (LF) power of the heart rate variability spectrum was significantly lower in bCBR patients in active wakefulness, sleep stage 1 and REM sleep. No differences were found between patients and controls for high frequency (HF) power and the LF/HF ratio. CONCLUSIONS: Bilateral carotid body tumor resection (bCBR) is associated with decreased low frequency power during sleep, suggesting impaired baroreflex function. Despite this, sleep-related heart rate changes were similar between bCBR patients and controls. These findings suggest that the effects of sleep on heart rate are predominantly generated through central, non-baroreflex mediated pathways.
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Niemeijer et al. (2015) conducted a case-control in Bilateral carotid body tumor resection (n=18). Bilateral carotid body tumor resection vs. Matched controls was evaluated on Heart rate and heart rate variability (LF power, HF power, LF/HF ratio). Bilateral carotid body tumor resection was associated with significantly lower low-frequency power of heart rate variability during active wakefulness, sleep stage 1, and REM sleep versus controls.
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