Physiological Markers of Arousal Change with Psychological Treatment for Insomnia: A Preliminary Investigation

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Dec 20

PMID 26683607

Citations 5

Authors

Christopher B Miller

Simon D Kyle

Christopher J Gordon

Colin A Espie

Ronald R Grunstein

Anna E Mullins

Svetlana Postnova

Delwyn J Bartlett

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this preliminary study was to evaluate if Sleep Restriction Therapy for insomnia is associated with modifications to physiological arousal, indexed through overnight measures of plasma cortisol concentrations and core body temperature.

Methods: In a pre-to-post open label study design, eleven patients with chronic and severe Psychophysiological Insomnia underwent 5 weeks of Sleep Restriction Therapy.

Results: Eight (73%) patients out of 11 consented completed therapy and showed a decrease in insomnia severity pre-to-post treatment (mean (SD): 18.1 (2.8) versus 8.4 (4.8); p = .001). Six patients were analyzed with pre-to-post overnight measures of temperature and cortisol. Contrary to our hypothesis, significantly higher levels of plasma cortisol concentrations were found during the early morning at post-treatment compared to baseline (p < .01), while no change was observed in the pre-sleep phase or early part of the night. Core body temperature during sleep was however reduced significantly (overall mean [95% CI]: 36.54 (°C) [36.3, 36.8] versus 36.45 [36.2, 36.7]; p < .05).

Conclusions: Sleep Restriction Therapy therefore was associated with increased early morning cortisol concentrations and decreased core body temperature, supporting the premise of physiological changes in functioning after effective therapy. Future work should evaluate change in physiological variables associated with clinical treatment response.

Trial Registration: Australian New Zealand Clinical Trials Registry ANZCTR 12612000049875.

Citing Articles

Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure.

Redeker N, Conley S, Anderson G, Cline J, Andrews L, Mohsenin V Behav Sleep Med. 2018; 18(2):190-202.

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Acceptability, tolerability, and potential efficacy of cognitive behavioural therapy for Insomnia Disorder subtypes defined by polysomnography: A retrospective cohort study.

Miller C, Espie C, Bartlett D, Marshall N, Gordon C, Grunstein R Sci Rep. 2018; 8(1):6664.

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Can body temperature dysregulation explain the co-occurrence between overweight/obesity, sleep impairment, late-night eating, and a sedentary lifestyle?.

Brown R, Thorsteinsson E, Smithson M, Birmingham C, Aljarallah H, Nolan C Eat Weight Disord. 2017; 22(4):599-608.

PMID: 28929462 DOI: 10.1007/s40519-017-0439-0.

Hyperarousal and Beyond: New Insights to the Pathophysiology of Insomnia Disorder through Functional Neuroimaging Studies.

Kay D, Buysse D Brain Sci. 2017; 7(3).

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Coralli A, Perciaccante A Sleep Sci. 2016; 9(1):5-6.

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