Cardiac irritability during sleep and dreaming

• Published in: Journal of psychosomatic research 1973-03, Vol.17 (2), p.129-134
• Main Authors: Rosenblatt, Gerald, Hartmann, Ernest, Zwilling, George R.
• Format: Article
• Language: English
• Subjects: Dreams; Heart - physiology; Humans; Sleep
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/0022-3999(73)90013-5

All-night polygraphic monitoring for a total of 30 nights was performed on ten subjects with known cardiac abnormalities—in most cases electrocardiographically proven myocardial infarction. Premature ventricular beats (PVB's) were observed most frequently during D-state (REM state) and with decreasing frequency in sleep stages 4, 2, and 3 in that order. The greatest incidence of PVB's was found at 2–6 a.m. coinciding with the time of highest frequency of D-periods and greatest variability in heart rate. Possible mechanisms for production of cardiac pathophysiology during D-state include increased autonomic activity resulting in marked heart rate variations and myocardial stimulation. Conversely, premature beats during stage 4 may be explained by periods of marked bradycardia allowing irritable myocardial foci to initiate cardiac arrhythmias. Modifying sleep stages for prevention of potentially fatal arrhythmias in susceptible individuals may be practical. The data suggest the possible use of drugs which decrease D-time and stage 4, as well as propranolol, atropine and other drugs based on the mechanisms of PVB production.