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
AuteursJarrin, DC, Chen, IY, Ivers, H, Lamy, M, Vallières, A, Morin, CM
JournalHealth Psychol
Date Published2016 Jun
KeywordsAdult, Cognitive Therapy, Female, Heart Rate, Humans, Male, Middle Aged, Polysomnography, Self Report, Sleep, Sleep Initiation and Maintenance Disorders

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

Alternate JournalHealth Psychol
PubMed ID27054300