Experimental Brain Research

, Volume 204, Issue 1, pp 71–78 | Cite as

Reduced heart rate variability predicts poor sleep quality in a case–control study of chronic fatigue syndrome

  • A. R. Burton
  • K. Rahman
  • Y. Kadota
  • A. Lloyd
  • U. Vollmer-Conna
Research Article


Parasympathetic function is important in the induction and maintenance of sleep. We examined whether nocturnal vagal modulation of heart rate is related to the poor sleep quality commonly reported in chronic fatigue syndrome (CFS). Heart rate (HR, as R–R intervals) was continuously monitored during sleep in 20 patients with CFS and 20 matched control subjects. Questionnaires assessed demographic information, symptoms, functional impairment, and subjective sleep quality. CFS was associated with more sleep problems in general and poorer subjective sleep quality on the study night (all p < 0.003), and reports of repeated awakening during the night were 7 times more likely compared to healthy subjects (p = 0.017). Time and frequency-domain parameters of HR variability during sleep were significantly lower in patients with CFS (all p < 0.006). Multiple regression analyses revealed that heart rate variability (HRV) parameters were the best predictors of subjective sleep measures. This study identified significant reductions in vagal modulation of heart rate during sleep in CFS. Low HRV strongly predicted sleep quality—suggesting a pervasive state of nocturnal sympathetic hypervigilance in CFS.


Chronic fatigue syndrome Sleep Heart rate variability Unrefreshing sleep Vagal tone Sympathetic hypervigilance 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • A. R. Burton
    • 1
  • K. Rahman
    • 1
  • Y. Kadota
    • 1
  • A. Lloyd
    • 2
  • U. Vollmer-Conna
    • 1
    • 3
  1. 1.School of PsychiatryUniversity of NSWSydneyAustralia
  2. 2.Centre for Infection and Inflammation Research, School of Medical SciencesUniversity of NSWSydneyAustralia
  3. 3.Department of Human Behaviour (Psychiatry)University of New South WalesSydneyAustralia

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