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Sleep patterns and blood pressure variability in patients with pure autonomic failure

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Abstract

Sleep patterns and 24-h blood pressure variability were studied in four female patients (age range: 56–82 years) with pure autonomic failure. All patients had severe symptomatic postural hypotension, without neurological deficits. In these patients the following patterns were observed: (i) a reversed diurnal blood pressure pattern, with the highest values observed at sleep onset; (ii) a prolonged sleep latency and increased amount of stage 3 sleep; (iii) difficulty with getting up after awakening in the morning, due to severe postural hypotension; (iv) an absence of prominent respiratory abnormalities during sleep; and (v) a dissociation between respiratory and haemodynamic findings. It is concluded that isolated deficiency of presumed postganglionic autonomic function influences sleep architecture, probably through absence of buffering of diurnal haemodynamic alterations, such as by postural hypotension and its consequences for body fluid volume regulation. This may be of relevance when sleep patterns are studied in other types of autonomic failure with postural hypotension involving central or preganglionic lesions, as in patients with the Shy—Drager syndrome or multiple system atrophy.

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Authors and Affiliations

  1. Department of Psychiatry, University Hospital Dijkzigt and Erasmus University Rotterdam, Rotterdam, The Netherlands

    J. H. M. Tulen MSc

  2. Department of Internal Medicine I, University Hospital Dijkzigt and Erasmus University Rotterdam, Rotterdam, The Netherlands

    A. J. Man in 't Veld MD, PhD

  3. Department of Clinical Neurophysiology, University Hospital Dijkzigt and Erasmus University Rotterdam, Rotterdam, The Netherlands

    H. G. van Steenis MSc & K. Mechelse MD, PhD

  4. Department of Section Pathophysiology of Behaviour, University Hospital Dijkzigt and Erasmus University Rotterdam, Rotterdam, The Netherlands

    J. H. M. Tulen MSc, H. G. van Steenis MSc & K. Mechelse MD, PhD

Authors
  1. J. H. M. Tulen MSc
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  2. A. J. Man in 't Veld MD, PhD
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  3. H. G. van Steenis MSc
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  4. K. Mechelse MD, PhD
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Tulen, J.H.M., Man in 't Veld, A.J., van Steenis, H.G. et al. Sleep patterns and blood pressure variability in patients with pure autonomic failure. Clinical Autonomic Research 1, 309–315 (1991). https://doi.org/10.1007/BF01819837

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  • DOI: https://doi.org/10.1007/BF01819837

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