Department of Neurology, Northwestern University, Feinberg School of Medicine, 60611 Chicago, IL, United States of America.
Department of Psychology, University of Arizona, Tucson, AZ, United States of America.
Auton Neurosci. 2019 Sep;220:102551. doi: 10.1016/j.autneu.2019.05.003. Epub 2019 May 16.
Insomnia is the most prevalent sleep disorder, particularly among middle and older aged adults, and is associated with a variety of negative health consequences, including higher risk for cardiovascular disease. Unfortunately, the mechanisms linking insomnia with cardiovascular risk remain largely unknown, thus limiting targeted therapeutic interventions. The hyperarousal hypothesis has attracted the most support, positing that insomnia is a result of multisystem over-activation, including sympathetic hyperactivity, which promotes wakefulness and blocks the occurrence of sleep at the desired time. The results from literature in support of this hypothesis are inconclusive and mainly relay on studies that used methods to assess sympathetic activity lacking in specificity and reproducibility. The present review aims at summarizing the primary findings on autonomic nervous system regulation in insomnia while highlighting the advantages and limitations of the methods mainly used to support the increase in sympathetic function in insomnia. Collectively, this review aims to provide novel perspectives on conceptualizing insomnia and suggest innovative approaches to help elucidate the relationship between insomnia and autonomic nervous system activity.
失眠是最常见的睡眠障碍，尤其在中年和老年人群中更为常见，与多种负面健康后果相关，包括心血管疾病风险增加。不幸的是，将失眠与心血管风险联系起来的机制在很大程度上仍不清楚，因此限制了有针对性的治疗干预。过度觉醒假说得到了最多的支持，该假说认为失眠是多系统过度激活的结果，包括交感神经活性增加，这促进了觉醒并阻止了在期望时间发生的睡眠。支持这一假设的文献结果并不确定，主要依赖于使用缺乏特异性和可重复性的方法来评估交感神经活性的研究。本综述旨在总结失眠症中自主神经系统调节的主要发现，同时强调主要用于支持失眠症中交感功能增加的方法的优点和局限性。总的来说，本综述旨在为失眠症的概念化提供新的视角，并提出创新方法来帮助阐明失眠症与自主神经系统活动之间的关系。
