Insomnia is the most prevalent sleep disorder, affecting 6-10% of the U.S.population, and is associated with a number of daytime sequelae. However, littleis known about the underlying neurobiological mechanisms that might lead toinsomnia. There is preliminary evidence that the stress system may play a majorrole in the etiology of insomnia. The goal of the present study is to examinewhether individuals with insomnia are more reactive to stress than healthysleepers. We hypothesize that insomniacs will show heightened reactivity to theanticipation of a stressor. The proposed project will include 20 individuals with primary insomnia and20 age- and gender-matched healthy sleeping controls. After collection ofbackground measures and an adaptation night in the sleep laboratory, subjectswill undergo a baseline and stress night. At 30 minutes before their habitualbedtime, upon awakening in the morning, and 30 minutes after waking up,subjects will provide a saliva sample and complete ratings of their current level ofstress. On the adaptation and baseline nights no additional procedures will takeplace. On the stress night a mild electric shock will be administered to thesubject after it is first demonstrated on the research personnel. They will then betold that they may receive up to 3 additional electric shocks during the night,although they will not actually receive any more shocks. The primary outcomemeasure is reactivity of sleep latency on the stress night compared to thebaseline night. Secondary outcome measures are: subjective ratings of stress,salivary cortisol and alpha-amylase, sleep quantity and quality, high frequencyEEG power, and heart rate variability. The results of this study will begin to determine whether the stress systemplays a role in the neurobiology of insomnia. Increasing our understanding of theetiology of insomnia may improve prevention and treatment of the condition andreduce the large public health burden of insomnia.
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| Gehrman, Philip R; Meltzer, Lisa J; Moore, Melisa et al. (2011) Heritability of insomnia symptoms in youth and their relationship to depression and anxiety. Sleep 34:1641-6 |
