We investigated cardiac vagal and sympathetic activity in 13 young primary insomniacs (PI; 24.4 ± 1.6 years) and 14 good sleepers (GS; 23.3 ± 2.5 years) during nocturnal sleep. Pre-ejection period (PEP; inversely related to beta-adrenergic sympathetic activity), interval between consecutive R-waves (RR), and vagal-related indices of time- and frequency-domain heart rate variability were computed during pre-sleep wakefulness and undisturbed arousal-free sleep stages (N2, SWS, REM) as well as across the whole night irrespective of the presence of disruptive sleep events (e.g. sleep arousals/awakenings) and/or sleep stage transitions. Groups exhibited a similar vagal activity throughout each undisturbed sleep stage as well as considering the whole night, with a higher modulation during sleep compared to prior wakefulness. However, PEP was constantly shorter (higher sympathetic activity) during pre-sleep wakefulness and each sleep stage in PI compared to GS. Moreover, pre-sleep RR intervals were positively associated with sleep efficiency and negatively associated with wake after sleep onset in PI. Altogether our findings indicated a dysfunctional sympathetic activity but a normal parasympathetic modulation before and during sleep in young adults with insomnia.
Facing Emotions in Narcolepsy with Cataplexy: Haemodynamic and Behavioural Responses During Emotional Stimulation
Narcolepsy with cataplexy is a complex sleep disorder that affects the modulation of emotions: cataplexy, the key symptom of narcolepsy, is indeed strongly linked with emotions that usually trigger the episodes. Our study aimed to investigate haemodynamic and behavioural responses during emotional stimulation in narco-cataplexy. Twelve adult drug-naive narcoleptic patients (five males; age: 33.3 ± 9.4 years) and 12 healthy controls (five males; age: 30.9 ± 9.5 years) were exposed to emotional stimuli (pleasant, unpleasant and neutral pictures). Heart rate, arterial blood pressure and mean cerebral blood flow velocity of the middle cerebral arteries were continuously recorded using photoplethysmography and Doppler ultrasound. Ratings of valence and arousal and coping strategies were scored by the Self-Assessment Manikin and by questionnaires, respectively. Narcoleptic patients’ haemodynamic responses to pictures overlapped with the data obtained from controls: decrease of heart rate and increase of mean cerebral blood flow velocity regardless of pictures’ content, increase of systolic blood pressure during the pleasant condition, and relative reduction of heart rate during pleasant and unpleasant conditions. However, when compared with controls, narcoleptic patients reported lower arousal scores during the pleasant and neutral stimulation, and lower valence scores during the pleasant condition, respectively, and also a lower score at the ‘focus on and venting of emotions’ dimensions of coping. Our results suggested that adult narcoleptic patients, compared with healthy controls, inhibited their emotion-expressive behaviour to emotional stimulation, and that may be related to the development of adaptive cognitive strategies to face emotions avoiding cataplexy.
Association between Personality Traits and DSM-IV Diagnosis of Insomnia in Peri- and Postmenopausal Women
The aim of this study was to determine the role of personality factors in the development of DSM-IV insomnia coincident with perimenopause.
Perimenopausal women (35 women with DSM-IV insomnia and 28 women with self-reported normal sleep) underwent clinical assessments and completed menopause-related questionnaires, the NEO Five Factor Inventory and the Structured Interview for DSM-IV Personality. Logistic regressions determined whether personality factors and hot flash-related interference were associated with an insomnia diagnosis concurrent with the menopausal transition.
Women with insomnia reported higher neuroticism, lower agreeableness, and lower conscientiousness than controls on the NEO Five Factor Inventory. Moreover, women with insomnia were more likely to meet DSM-IV criteria for cluster C personality disorders, particularly obsessive-compulsive personality disorder, on the Structured Interview for DSM-IV Personality. Women with insomnia were more likely to have had a past depressive episode and a history of severe premenstrual symptoms. Findings from regressions revealed that higher neuroticism and greater interference from hot flashes were associated with insomnia classification even after controlling for history of depression, suggesting that sensitivity to hot flashes and a greater degree of neuroticism are independent contributors toward establishing which women are most likely to have sleep problems during perimenopause.
Findings show the relevance of personality factors, particularly neuroticism and obsessive-compulsive personality, to a woman’s experience of insomnia as she goes through the menopausal transition.
Poor Autonomic Nervous System Functioning During Sleep in Recently Detoxified Alcohol-Dependent Men and Women
Alcoholism is considered an important risk factor for cardiovascular (CV) disease. Autonomic nervous system (ANS) function is a major indicator of CV health. Sleep is a suitable model to investigate ANS activity free from wake-related confounders. We investigated nighttime ANS functioning, and the relation between ANS activity and severity of alcohol dependence in chronic alcoholism.
Fourteen recently abstaining alcoholics (age: 42.0 ± 9.0 years, 7 women) and 16 age- and sex-matched controls (age: 45.2 ± 9.1 years, 8 women) underwent a night of standard clinical polysomnography, including electrocardiographic recording. Time- and frequency-domain spectral analysis of heart rate variability (HRV) was performed across hours of the night and during artifact-free epochs of stable sleep and wakefulness (presleep wakefulness, rapid-eye-movement [REM], and non-REM sleep).
Alcoholics had a poorer subjective and objective sleep quality compared to controls. Across the night, alcoholic men and women had elevated heart rate, reduced total HRV, that is, lower standard deviation of normal-to-normal interbeat intervals, and reduced high frequency (HF) activity (assessed by the HF power and by the square root of the mean squared of successive heart period differences). This ANS pattern was most apparent at the beginning of the night. None of the ANS measures was associated with lifetime alcohol consumption or duration of alcohol dependence.
Our results show that ANS functioning is disrupted during the night, even in undisturbed sleep periods, indicating poor CV functioning in recently detoxified alcohol-dependent men and women.
We investigated memory performance and cardiovascular activity in 13 primary insomniacs (PI) compared to 13 good sleepers (GS). Cardiovascular and hemodynamic measures, including heart rate, pre-ejection period, and blood pressure, were continuously recorded at rest and during two memory tasks. PI showed working memory impairment under high cognitive load, but performed as well as GS in an easy memory task. In addition, PI exhibited markers of hyperarousal both at rest and during the execution of the two tasks. However, we failed to find a clear-cut relationship between cardiovascular hyperarousal and cognitive performance in insomniacs. Our data provide further evidence of both cognitive impairment and cardiovascular hyperarousal in primary insomnia, while not supporting the hypothesis of hyperarousal as a compensatory mechanism to overcome cognitive challenges.
SRI Authors: Ian M. Colrain, Fiona C Baker, Massimiliano de Zambotti Abstract Objective Little is known about the impact of hot flashes on cardiac autonomic regulation, in particular vagal control. Thereby, we assessed the cardiac autonomic profile associated with physiological hot flashes occurring in undisturbed sleep. Methods Eleven perimenopausal women (45 to 56 years) had […]
Autonomic Regulation across Phases of the Menstrual Cycle and Sleep Stages in Women with Premenstrual Syndrome and Healthy Controls
Abstract To investigate the influence of menstrual cycle phase and the presence of severe premenstrual symptoms on cardiac autonomic control during sleep, we performed heart rate variability (HRV) analysis during stable non-rapid eye movement (NREM) and REM sleep in 12 women with severe premenstrual syndrome and 14 controls in the mid-follicular, mid-luteal, and late-luteal phases […]
SRI Authors: Massimiliano de Zambotti
Cardiovascular Down-Regulation in Essential Hypotension: Relationships with Autonomic Control and Sleep
SRI Authors: Massimiliano de Zambotti
Polysomnographic Validation of a Wireless Dry Headband Technology for Sleep Monitoring in Healthy Young Adults
SRI Authors: Massimiliano de Zambotti