Nighttime cardiac sympathetic hyper-activation in young primary insomniacs

Purpose A growing literature supports the association between insomnia and cardiovascular risk. Since only few studies have provided empirical evidence of hyper-activation of the cardiovascular system in insomniacs, the aim of the present study was to analyze cardiac autonomic responses in primary i...

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Bibliographic Details
Published in:Clinical autonomic research 2013-02, Vol.23 (1), p.49-56
Main Authors: de Zambotti, M., Covassin, N., Sarlo, M., De Min Tona, G., Trinder, J., Stegagno, L.
Format: Article
Language:English
Subjects:
Adult
Cardiography, Impedance
Cardiology
Cardiovascular diseases
Cardiovascular Diseases - physiopathology
Cardiovascular system
Diabetes
Electrocardiography
Endocrinology
Female
Gastroenterology
Heart
Heart rate
Heart Rate - physiology
Humans
Male
Medicine
Medicine & Public Health
Neurology
Nighttime
Ophthalmology
Polysomnography
Research Article
Risk Factors
Sleep - physiology
Sleep and wakefulness
Sleep disorders
Sleep Initiation and Maintenance Disorders - physiopathology
Sympathetic Nervous System - physiopathology
Young Adult
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Summary:Purpose A growing literature supports the association between insomnia and cardiovascular risk. Since only few studies have provided empirical evidence of hyper-activation of the cardiovascular system in insomniacs, the aim of the present study was to analyze cardiac autonomic responses in primary insomnia. Methods Impedance cardiography and heart rate variability (HRV) measures were assessed in 9 insomniacs and 9 good sleepers during a night of polysomnographic recording. Results Insomniacs were found to be characterized by a constant sympathetic hyper-activation which was maintained all night, as suggested by a faster pre-ejection period (PEP) compared to good sleepers. In addition, only insomniacs showed a strong reduction in heart rate in the transition from wake to sleep. Both groups exhibited a reduction in cardiac output and sympathovagal balance, i.e., reductions in low-frequency/high-frequency ratio and increases in high-frequency normalized units of HRV, across the night. In addition, in our sample, a high physiological sympathetic activation (fast PEP) at night was found to be directly associated with low quality of sleep. Conclusions These preliminary findings suggest that a constant cardiac sympathetic hyper-activation throughout the night is a main feature of primary insomnia. Our evidences support the association between insomnia and increased risk for cardiovascular diseases.
ISSN:0959-9851
1619-1560
DOI:10.1007/s10286-012-0178-2