Cardiovascular autonomic changes during rapid eye movement sleep

Cardiovascular autonomic changes during rapid eye movement sleep

What cardiovascular autonomic changes are seen during rapid eye movement (REM) sleep? 

During REM sleep, sympathetic activity of the splanchnic and renal circulation is decreased, but activity by skeletal muscles is increased.

Whereas the slow phases of sleep are accompanied by hypotension and bradycardia, which become increasingly more pronounced with the progression of sleep from stage 1 to stage 4, REM sleep is associated with large, transient increases in blood pressure, reversing the hypotension of slow-wave sleep.

Direct recording of sympathetic nerve traffic to the skeletal muscle vascular bed by microneurography shows more than a 50% reduction in sympathetic activity during the slow phases of sleep but a significant increase to the level of wakefulness during REM.

This finding may suggest that slow-wave sleep provides a protective effect on the cardiovascular and cerebrovascular systems; during REM sleep or immediately afterward, such protective effects may disappear.

This phenomenon may explain why cardiovascular and cerebrovascular events occur more frequently in the early morning hours after awakening.

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