Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025, USA.
Center for Vision Technologies, SRI International, Princeton, NJ, USA.
J Behav Med. 2019 Oct;42(5):973-983. doi: 10.1007/s10865-019-00020-9. Epub 2019 Feb 21.
Hyperarousal is a critical component of insomnia, particularly at bedtime when individuals are trying to fall asleep. The current study evaluated the effect of a novel, acute behavioral experimental manipulation (combined immersive audio-visual relaxation and biofeedback) in reducing bedtime physiological hyperarousal in women with insomnia symptoms. After a clinical/adaptation polysomnographic (PSG) night, sixteen women with insomnia symptoms had two random-order PSG nights: immersive audio-visual respiratory bio-feedback across the falling asleep period (manipulation night), and no pre-sleep arousal manipulation (control night). While using immersive audio-visual respiratory bio-feedback, overall heart rate variability was increased and heart rate (HR) was reduced (by ~ 5 bpm; p < 0.01), reflecting downregulation of autonomic pre-sleep arousal, relative to no-manipulation. HR continued to be lower during sleep, and participants had fewer awakenings and sleep stage transitions on the manipulation night relative to the control night (p < 0.05). The manipulation did not affect sleep onset latency or other PSG parameters. Overall, this novel behavioral approach targeting the falling asleep process emphasizes the importance of pre-sleep hyperarousal as a potential target for improving sleep and nocturnal autonomic function during sleep in insomnia.
过度觉醒是失眠的一个关键组成部分，特别是在人们试图入睡的睡前阶段。本研究评估了一种新的急性行为实验操作（组合沉浸式视听放松和生物反馈）在减少失眠症状女性睡前生理过度觉醒的效果。在进行临床/适应多导睡眠图（PSG）夜间后，16 名有失眠症状的女性进行了两次随机顺序 PSG 夜间：在入睡期间使用沉浸式视听呼吸生物反馈（操作夜间），以及没有睡前唤醒操作（对照夜间）。在使用沉浸式视听呼吸生物反馈时，整体心率变异性增加，心率（HR）降低（约 5 次/分钟；p<0.01），反映了自主睡眠前唤醒的下调，与无操作相比。HR 在睡眠期间继续降低，并且参与者在操作夜间比对照夜间有更少的觉醒和睡眠阶段转换（p<0.05）。该操作不会影响睡眠潜伏期或其他 PSG 参数。总体而言，这种针对入睡过程的新型行为方法强调了睡前过度觉醒作为改善失眠期间睡眠和夜间自主功能的潜在目标的重要性。
