0402 Pre-Sleep Psychophysiological Downregulation in Women with Insomnia Symptoms

Introduction Insomnia is a common complaint, being present in about a third of the adult population, with a greater prevalence in women. Insomnia is characterized by difficulties initiating and maintaining sleep, often attributed to an underlying state of psychological and physiological hyperarousal. Hyperarousal is particularly magnified in insomnia sufferers under specific circumstances, such as when trying to fall asleep. The current study explored the feasibility of lowering the state of hyperarousal before sleep using a novel approach of immersive audio-visual respiratory bio-feedback in women with insomnia symptoms. Methods Sixteen women (43.4±13.31 years) complaining of sleep difficulties (difficulty falling asleep and/or maintaining sleep) at least 3 times per week, for at least 1 month, with symptoms interfering with daytime functioning, participated in the study. Following an adaptation night, they had two randomized polysomnographic (PSG) nights: pre-sleep downregulation (use of immersive audio-visual respiratory bio-feedback across the falling asleep period) and control night (no pre-sleep manipulation). For the pre-sleep downregulation night, women were instructed to perform slow diaphragmatic breathing; they were wearing a customized sleeping mask which provided audio-visual feedback according to their breathing rate. On the control night, women were only instructed to follow typical bedtime routines. Results While performing immersive audio-visual respiratory bio-feedback, total heart rate variability (HRV) was increased and heart rate (HR) was reduced by 5bpm (p.05) between nights, however women reported feeling significantly less stressed (p=.028) following the pre-sleep downregulation night. Conclusion Immersive audio-visual respiratory bio-feedback was effective in lowering pre-sleep HR and increasing HRV, reflecting lower autonomic arousal, in women with insomnia symptoms. These preliminary data suggested that pre-sleep hyperarousal may be a potential target for improving sleep and autonomic functioning during sleep in insomnia. Support (If Any) This study was funded by the National Institutes of Health (NIH), Grant HL10