Heart rate and heart rate variability in subjectively reported insomnia

Kai Spiegelhalder, Lena Fuchs, Johannes Ladwig, Simon D. Kyle, Christoph Nissen, Ulrich Voderholzer, Bernd Feige, Dieter Riemann

    Research output: Contribution to journalArticlepeer-review


    According to epidemiological studies, insomnia is associated with cardiovascular mortality. However, it is yet to be determined whether this link is mediated by known cardiovascular risk factors. The current study aimed at investigating the association between primary insomnia, defined as subjectively reported sleep disturbance in the absence of any other pathology or substance intake, and alterations in polysomnographically determined nocturnal heart rate (HR) and heart rate variability (HRV). A total of 4581 nocturnal short-term electrocardiographic recordings (5min each) from 104 participants (58 with primary insomnia, 46 healthy controls) were evaluated for HR as well as for time and frequency domain measures of HRV. In the primary insomnia group, we found a lower wake-to-sleep HR reduction and a lower standard deviation of RR intervals (SDNN) compared to healthy controls. However, between-group differences in resting HR were not found, and previous results of an increase in sympathovagal balance and a decrease in parasympathetic nocturnal activity in objectively determined insomnia could not be confirmed in our sample of self-report insomnia patients. When restricting our analyses to insomnia patients with objectively determined short sleep duration, we found reduced parasympathetic activity as indicated by decreased high frequency power of HRV, as well as decreased root mean square of successive RRI differences (RMSSD) and percentage of successive RRIs that differ by more than 50ms (pNN50) values. A lower wake-to-sleep HR reduction and alterations in HRV variables might, at least partially, mediate the increased rates of cardiovascular morbidity and mortality observed in insomnia patients. © 2010 European Sleep Research Society.
    Original languageEnglish
    Pages (from-to)137-145
    Number of pages8
    JournalJournal of Sleep Research
    Issue number1
    Publication statusPublished - Mar 2011


    • Autonomic nervous system
    • Heart rate
    • Heart rate variability
    • Primary insomnia


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