Nocturnal heart rate variability in patients treated with cognitive-behavioral therapy for insomnia.

TitleNocturnal heart rate variability in patients treated with cognitive-behavioral therapy for insomnia.
Publication TypeJournal Article
Year of Publication2016
AuthorsJarrin, DC, Chen, IY, Ivers, H, Lamy, M, Vallières, A, Morin, CM
JournalHealth Psychol
Volume35
Issue6
Pagination638-41
Date Published2016 Jun
ISSN1930-7810
KeywordsAdult, Cognitive Therapy, Female, Heart Rate, Humans, Male, Middle Aged, Polysomnography, Self Report, Sleep, Sleep Initiation and Maintenance Disorders
Abstract

OBJECTIVE: Insomnia and reduced heart rate variability (HRV) increase the risk of cardiovascular disease and its precursors; thus, it is important to evaluate whether treatment for insomnia provides cardiovascular safeguards. The present study aimed to evaluate potential cardiovascular benefits of cognitive behavioral therapy for insomnia (CBT-I).METHOD: The present study included 65 patients treated for chronic insomnia (M = 51.8 years, SD = 10.0; 66.2% female) at a university hospital. Patients received CBT-I over a 6-week period, and change scores from pre- to posttreatment derived from the Insomnia Severity Index, sleep diary, and polysomnography (PSG) were used as indices of sleep improvement. HRV variables (i.e., low frequency [LF], high frequency [HF], and the ratio of low to high frequency [LF:HF ratio]) were derived for Stage 2 (S2) and rapid-eye movement (REM) sleep at pre- and posttreatment. High HF (i.e., parasympathetic activity) and/or low LF:HF ratio (i.e., sympathovagal balance) were used as indices of HRV improvement.RESULTS: Following therapy, sleep improvements, particularly for sleep onset latency, were related with reduced HF in S2 (r = .30, p < .05) and in REM (r = .36, p < .01). A trend was also observed between reduced insomnia symptoms and increased HF in REM (r = -.21, p < .10).CONCLUSIONS: Findings suggest that contrary to expectations, sleep improvements following CBT-I were associated with reduced parasympathetic activation and increased sympathovagal balance. Although preliminary, these results raise the question as to whether insomnia treatment might play a role in physiological changes associated with cardiovascular anomalies. Future research is needed to examine the long-term impact of treatment as a preventative tool against insomnia-related morbidity. (PsycINFO Database Record

DOI10.1037/hea0000347
Alternate JournalHealth Psychol
PubMed ID27054300