Key result
Participants with long sleep onset latency exhibited significantly lower high-frequency normalized spectral power (HFnu) across three time periods around sleep onset compared to those with short sleep onset latency, suggesting increased autonomic arousal.
Why the study?
Insomnia is one of the most common sleep disorders, prompting investigation into autonomic activity changes around sleep onset as potential underlying mechanisms.
Is cardiac autonomic activity associated with sleep onset latency and wake after sleep onset in participants without clinical insomnia?
Observational (n=176)
Yes
Is cardiac autonomic activity associated with sleep onset latency and wake after sleep onset in participants without clinical insomnia?
p-value: p=<0.05
Increased sympathetic and decreased parasympathetic cardiac autonomic activity around sleep onset is associated with longer sleep onset latency and increased wake after sleep onset.
Autonomic shifts at sleep onset may aid insomnia phenotyping in young adults; hypothesis-generating and should not yet change practice.
Insomnia, i.e. difficulties initiating and/or maintaining sleep, is one of the most common sleep disorders. To study underlying mechanisms for insomnia, we studied autonomic activity changes around sleep onset in participants without clinical insomnia but with varying problems with initiating or maintaining sleep quantified as increased sleep onset latency (SOL) and wake after sleep onset (WASO) respectively. Polysomnography and electrocardiography were simultaneously recorded in 176 participants during a single night. Cardiac autonomic activity was assessed using frequency domain analysis of RR intervals and results show that the normalised spectral power in the low frequency band (LFnu) after sleep onset was significantly higher in participants with long SOL compared to participants with short SOL. Furthermore, the normalised spectral power in the high frequency band (HFnu) was significantly lower in participants with long SOL as compared to participants with short SOL over 3 time periods (first 10 minutes in bed intending to sleep, 10 minutes before and 10 minutes after sleep onset). These results suggest that participants with long SOL are more aroused in all three examined time periods when compared to participants with short SOL, especially for young adults (20-40 years). As there is no clear consensus on the cutoff for an increased WASO, we we used a data-driven approach to explore different cutoffs to define short WASO and long WASO groups. LFnu, HFnu and LF/HF differed between the long and the short WASO groups. A higher LFnu and LF/HF and a lower HFnu was observed in participants with long WASO for most cutoffs. The highest effect size was found using the cutoff of 66 min. Our findings suggest that autonomic cardiac activity has predictive value with respect to sleep characteristics pertaining to sleep onset and maintenance
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Nano et al. (2020) conducted an observational in Sleep onset and maintenance difficulties (n=176). Long sleep onset latency (>30 min) and long wake after sleep onset vs. Short sleep onset latency (≤30 min) and short wake after sleep onset was evaluated on High frequency normalized spectral power (HFnu) during the first 10 min in bed intending to sleep (p=<0.05). Participants with long sleep onset latency exhibited significantly lower high-frequency normalized spectral power (HFnu) across three time periods around sleep onset compared to those with short sleep onset latency, suggesting increased autonomic arousal.
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