title: Insomnia symptoms and heart rate recovery among patients in cardiac rehabilitation.
abstract: Insomnia symptoms (i.e., difficulty falling asleep, difficulty staying asleep, and early morning awakenings) are common among people with cardiovascular disease, and have been linked to adverse cardiovascular health outcomes. Reduced parasympathetic tone is one pathway through which risk may be conferred. The purpose of this study was to evaluate whether insomnia symptoms are associated with lower parasympathetic tone in cardiac rehabilitation patients with suspected insomnia. Participants (N = 121) completed a self-report measure of insomnia severity. 1-min heart rate recovery (HRR), an index of parasympathetic tone, was obtained during a maximal exercise test. Difficulty falling asleep, but not difficulty staying asleep or early awakenings, was associated with attenuated 1-min HRR. When analyses were restricted to participants with moderate and severe insomnia severity (n = 51), the strength of this association increased. In a sample of cardiac rehabilitation patients with insomnia, only the symptom of difficulty falling asleep was associated with lower parasympathetic tone, suggesting that individual insomnia symptoms may show specificity in their associations with physiological mechanisms.
authors.affiliation: Department of Psychology, McGill University, Montreal, QC, Canada.
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Horsley
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada.
authors.forename: Codie R
authors.initials: CR
authors.lastname: Rouleau
authors.affiliation: Department of Psychology, Memorial University, St. John's, NL, Canada.
authors.forename: Sheila N
authors.initials: SN
authors.lastname: Garland
authors.affiliation: Department of Family Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Samuels
authors.affiliation: TotalCardiology™ Rehabilitation, Calgary, AB, Canada.|Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Sandeep G
authors.initials: SG
authors.lastname: Aggarwal
authors.affiliation: TotalCardiology™ Rehabilitation, Calgary, AB, Canada.|Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: James A
authors.initials: JA
authors.lastname: Stone
authors.affiliation: Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada. t.s.campbell@ucalgary.ca.
authors.forename: Tavis S
authors.initials: TS
authors.lastname: Campbell
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000503:physiopathology
keywords: Cardiac rehabilitation; Heart rate recovery; Insomnia symptoms; Parasympathetic tone