NEW YORK (Reuters Health) – Chronic insomnia is associated with impaired sympathetic baroreflex function and augmented neural responsiveness to stress, which can contribute to an increased cardiovascular risk, researchers report.
Chronic insomnia, which affects up to 15% of adults worldwide, has been linked to hypertension and the risk of cardiovascular disease, but the mechanisms underlying these associations remain unclear.
Dr. Jason R. Carter and colleagues from the University of Chicago and Michigan Technological University, in Houghton, evaluated sympathetic neural outflow, baroreflex sensitivity and sympathetic neural and cardiovascular reactivity to stress in 13 individuals with chronic insomnia and 15 healthy controls.
Resting blood pressure, heart rate, and muscle sympathetic nerve activity did not differ significantly between groups, but baseline sympathetic baroreflex sensitivity was significantly blunted in individuals with insomnia, the team reports in Sleep, online March 7.
Systolic blood pressure reactivity to stress was elevated in individuals with insomnia, as was their muscle sympathetic nerve activity response to stress, compared with controls.
“Our findings point at sympathetic overactivity and baroreflex dysfunction as potential mechanisms underlying the reported links between chronic insomnia and hypertension,” the researchers conclude. “Taken together with the epidemiologic evidence, these observations support the view that chronic insomnia is a psychophysiological disorder associated with an elevated cardiovascular risk.”
“Future longitudinal studies might consider the impact of interventions such as cognitive behavioral therapy for insomnia and/or pharmacological treatment on sympathetic neural and cardiovascular regulation in patients with chronic insomnia,” they add.
Dr. Renaud Tamisier of the University Grenoble Alpes, in Grenoble, France, who recently reviewed hemodynamic and autonomic control in patients with sleep disorders, told Reuters Health by email, “There is undoubtedly a close link between insomnia and cardiovascular disease. Sympathetic vascular tone and its reactivity are among the main factors impaired in sleep disorders. In the present article, the authors also demonstrated that sympathetic regulation was impaired, with a decrease in baroreflex gain in patient suffering from insomnia.”
“Restoring sleep quality in a patient with insomnia should be a goal in order to prevent sympathetic overactivity and therefore hypertension genesis,” he said. “In patients with insomnia and hypertension, pharmacological agents dedicated to decrease blood pressure should target the sympathetic cardiovascular system.”
Dr. Tamisier added, “Lifestyle management of cardiovascular risk, which include diet (and) exercise, should include strategies that will improve sleep quality and duration.”
Dr. Carter did not respond to a request for comments.
SOURCE: https://bit.ly/2JJHBUb
Sleep 2018.
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