Cardiovascular Autonomic Control, Sleep and Health Related Quality of Life in Systemic Sclerosis
Open Access
- 25 February 2021
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 18 (5), 2276
- https://doi.org/10.3390/ijerph18052276
Abstract
Chronic pain and dysautonomic symptoms deteriorate Systemic sclerosis (SSc) patients’ health-related quality of life with serious repercussions on social life and even on sleep. Heart Rate Variability (HRV) analysis can identify cardiovascular autonomic control impairment in subclinical condition. The aim of the present observational cross-sectional study was to assess the relationship between dysautonomic symptoms, quality of life status and cardiovascular autonomic profile. ECG and respiration were recorded at rest in 20 SSc patients. HRV analysis was performed using two different approaches: Linear spectral analysis and non-linear symbolic analysis. Pain was evaluated using the Numeric Rating Scale (NRS) and 3 questionnaires were administered for the evaluation of sleep quality (PSQI), mood tone (PHQ-9) and disability (HAQ). We found that sleep impairment was related to sympathetic predominance at rest measured as low-frequency/high-frequency ratio (LF/HF) (r = 0.48 and p = 0.033); poorer sleep quality was related to higher pain values (r = 0.48 and p = 0.034) and depressive symptoms (r = 0.82 and p < 0.01); higher pain scores were related to higher cardiovascular vagal modulation and higher disability indexes (r = 0.47 and p = 0.038 & r = 0.55 and p = 0.012, respectively). In conclusion dysautonomia and chronic pain showed a severe impact on sleep quality and disability with a consequent worsening of depressive symptom in our cohort of SSc patients.Funding Information
- Italian Ministry of Health (Ricerca Corrente RC- 2019)
This publication has 48 references indexed in Scilit:
- Heart rate variability in normal and pathological sleepFrontiers in Physiology, 2013
- Frequency and impact of symptoms experienced by patients with systemic sclerosis: results from a Canadian National SurveyRheumatology, 2010
- Epidemiology of chronic non-cancer pain in Europe: narrative review of prevalence, pain treatments and pain impactCurrent Medical Research and Opinion, 2010
- Prevalence, severity, and clinical correlates of pain in patients with systemic sclerosisArthritis Care & Research, 2010
- Impact of digital ulcers on disability and health-related quality of life in systemic sclerosisAnnals Of The Rheumatic Diseases, 2009
- Pain-autonomic interactionsNeurological Sciences, 2006
- The autonomic nervous system in systemic sclerosis. A reviewClinical Rheumatology, 2003
- Sleep disruption in systemic sclerosis (scleroderma) patients: clinical and polysomnographic findingsSleep Medicine, 2002
- The PHQ-9Journal of General Internal Medicine, 2001
- Autonomic nervous system dysfunction in sclerodermic and primary Raynaud’s phenomenonClinical Science, 1999