Summary
Sleep patterns of two young female patients with congenital dopamine beta-hydroxylase deficiency are described. In this orthostatic syndrome central and peripheral noradrenergic failure occurs as a result of impaired beta-hydroxylation of dopamine. Consequently, the levels of dopamine and its metabolites are elevated. The relative importance of noradrenaline deficit in the face of dopamine excess for sleep-regulatory mechanisms can be inferred from the sleep pattern of these patients. No subjective sleep complaints were reported. The sleep patterns showed a high percentage of slow-wave sleep in both patients (29% and 34% of sleep period time) and a relatively low to normal percentage of REM sleep (18% and 21%). A normal cyclic REM sleep pattern was observed. Alpha-delta sleep occurred during light sleep (15% and 8%); consequently, the amount of stage 2 sleep was reduced. These results indicate that functional insufficiency of the noradrenergic system in two patients with dopamine beta-hydroxylase deficiency is not associated with profound changes in the (REM) sleep pattern. This supports a modulatory or permissive role for noradrenaline in REM sleep mechanisms.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Borbély A, Valatx JL (eds) (1984) Sleep mechanisms. Exp Brain Res [Suppl 8]. Springer, Berlin Heidelberg New York
Cianchetti C (1985) Dopamine agonists and sleep in man. In: Wauquier A, Gaillard JM, Monti JM, Radulovacki M (eds) Sleep: neurotransmitters and neuromodulators. Raven Press, New York, pp 121–134
Corsini GU, Del Zompe M, Manconi S, Piccardi MP, Onali PL, Mangoni A (1977) Evidence for dopamine receptors in the human brain mediating sedation and sleep. Life Sci 20:1613–1618
Fry JM, Pressman MR, DiPhillipo MA (1987) Alpha-delta sleep and disorders of excessive somnolence. In: Chase MH, McGinty DJ, O'Connor C (eds) Sleep research. Brain Research Institute, Los Angeles, p 333
Gaillard JM (1985) Involvement of noradrenaline in wakefulness and paradoxical sleep. In: Wauquier A, Gaillard JM, Monti JM, Radulovacki M (eds) Sleep: neurotransmitters and neuromodulators. Raven Press, New York, pp 57–67
Hauri P, Hawkins DR (1973) Alpha-delta sleep. Electroencephalogr Clin Neurophysiol 34:233–237
Hobson JA, Lydic R, Baghdoyan HA (1986) Evolving concepts of sleep cycle generation: from brain centers to neuronal populations. Behav Brain Sci 9:371–448
Karacan L, Williams RL, Finley WW, Hursch CJ (1970) The effects of naps on nocturnal sleep: influence of the need for stage 1-REM and stage 4 sleep. Biol Psychiatry 2:391–399
Lavie P, Gertner R, Zomer J, Podoshin L (1981) Breathing disorders in sleep associated with “microarousals” in patients with allergic rhinitis. Acta Otolaryngol (Stockh) 92:529–533
Man in't Veld AJ, Van den Meiracker AH, Ritsema van Eck HJ, Wenting GJ, Schalekamp MADH (1986) Blood pressure variability during ambulation, bedrest and sensory deprivation in hypertension and autonomic failure. In: Christensen NJ, Henriksen O, Lassen NA (eds) The sympathoadrenal system. Munksgaard, Copenhagen, pp 116–126
Man in't Veld AJ, Boomsma F, Moleman P, Schalekamp MADH (1987) Congenital dopamine-beta-hydroxylase deficiency. A novel orthostatic syndrome. Lancet I:183–188
Man in't Veld AJ, Boomsma F, Van den Meiracker AH, Schalekamp MADH (1987) Effect of an unnatural noradrenaline precursor on sympathetic control and orthostatic hypotension in dopamine beta-hydroxylase deficiency. Lancet II:1172–1175
Man in't Veld AJ, Boomsma F, Lenders J, Van den Meiracker AH, Julien C, Tulen JHM, Moleman P, Thien T, Lamberts S, Schalekamp MADH (1988) Patients with dopamine beta-hydroxylase deficiency; a lesson in catecholamine physiology. Am J Hypertens 1:231–238
Meiracker AH van den, Man in't Veld AJ, Ritsema van Eck HJ, Boomsma F, Schalekamp MADH (1988) Hemodynamic and hormonal adaptations to beta-adrenoceptor blockade. A 24-hour study of acebutolol, atenolol, pindolol and propranolol in hypertensive patients. Circulation 78:957–968
Moldofsky H (1986) Sleep and musculoskeletal pain. Am J Med 81 [Suppl 3A]:85–89
Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. UCLA Brain Information Service Research Institute, Los Angeles
Sagales T, Erill S (1975) Effects of central dopaminergic blockade with pimozide upon the EEG stages of sleep in man. Psychopharmacology 41:53–56
Sakai K (1985) Anatomical and physiological basis of paradoxical sleep. In: McGinty DJ, Drucker-Colin R, Morrison A, Parmeggiani L (eds) Brain mechanisms of sleep. Raven Press, New York
Schalekamp MADH, Man in't Veld AJ, Wenting BJ (1985) What regulates whole body autoregulation? J Hypertens 3:97–108
Schulz H (1986) Schlafstruktur und Schlafperiodik. Habilitationsschrift. Technische Universität, Fakultät für Wirtschaftsund Sozialwissenschaften, Munich
Silverstein LD, Levy CM (1976) The stability of the sigma sleep spindle. Electroencephalogr Clin Neurophysiol 40:666–670
Wauquier A, Clincke GHC, Van den Broek WAE, De Prins E (1985) Active and permissive roles of dopamine in sleep-wakefulness regulation. In: Wauquier A, Gaillard JM, Monti JM, Radulovacki M (eds) Sleep: neurotransmitters and neuromodulators. Raven Press, New York, pp 107–120
Wauquier A, Gaillard JM, Monti JM, Radulovacki M (eds) (1985) Sleep: neurotransmitters and neuromodulators. Raven Press, New York
Williams RL, Karacan I, Hursch CJ (1974) EEG of human sleep: clinical applications. Wiley, New York
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tulen, J.H.M., Man in't Veld, A.J., Mechelse, K. et al. Sleep patterns in congenital dopamine beta-hydroxylase deficiency. J Neurol 237, 98–102 (1990). https://doi.org/10.1007/BF00314670
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00314670