title: Heart rate and heart rate variability modification in chronic insomnia patients.
abstract: Chronic insomnia is highly prevalent in the general population, provoking personal distress and increased risk for psychiatric and medical disorders. Autonomic hyper-arousal could be a pathogenic mechanism of chronic primary insomnia. The aim of this study was to investigate autonomic activity in patients with chronic primary insomnia by means of heart rate variability (HRV) analysis. Eighty-five consecutive patients affected by chronic primary insomnia were enrolled (38 men and 47 women; mean age: 53.2 ± 13.6). Patients were compared with a control group composed of 55 healthy participants matched for age and gender (23 men and 32 women; mean age: 54.2 ± 13.9). Patients underwent an insomnia study protocol that included subjective sleep evaluation, psychometric measures, and home-based polysomnography with evaluation of HRV in wake before sleep, in all sleep stages, and in wake after final awakening. Patients showed modifications of heart rate and HRV parameters, consistent with increased sympathetic activity, while awake before sleep and during Stage-2 non-REM sleep. No significant differences between insomniacs and controls could be detected during slow-wave sleep, REM sleep, and post-sleep wake. These results are consistent with the hypothesis that autonomic hyper-arousal is a major pathogenic mechanism in primary insomnia, and confirm that this condition is associated with an increased cardiovascular risk.
authors.affiliation: a Department of Human Sciences, Cognitive and Clinical Psychology Lab Università Europea , Rome , Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Farina
authors.forename: Serena
authors.initials: S
authors.lastname: Dittoni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Colicchio
authors.forename: Elisa
authors.initials: E
authors.lastname: Testani
authors.forename: Anna
authors.initials: A
authors.lastname: Losurdo
authors.forename: Valentina
authors.initials: V
authors.lastname: Gnoni
authors.forename: Chiara
authors.initials: C
authors.lastname: Di Blasi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Brunetti
authors.forename: Anna
authors.initials: A
authors.lastname: Contardi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mazza
authors.forename: Giacomo
authors.initials: G
authors.lastname: Della Marca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001143:Arousal / Q000502:physiology*; D001341:Autonomic Nervous System / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000503:physiopathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D004198:Disease Susceptibility; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology; D014851:Wakefulness / Q000502:physiology