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Reducing bedtime physiological arousal levels using immersive audio-visual respiratory bio-feedback: a pilot study in women with insomnia symptoms

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Abstract

Hyperarousal is a critical component of insomnia, particularly at bedtime when individuals are trying to fall asleep. The current study evaluated the effect of a novel, acute behavioral experimental manipulation (combined immersive audio-visual relaxation and biofeedback) in reducing bedtime physiological hyperarousal in women with insomnia symptoms. After a clinical/adaptation polysomnographic (PSG) night, sixteen women with insomnia symptoms had two random-order PSG nights: immersive audio-visual respiratory bio-feedback across the falling asleep period (manipulation night), and no pre-sleep arousal manipulation (control night). While using immersive audio-visual respiratory bio-feedback, overall heart rate variability was increased and heart rate (HR) was reduced (by ~ 5 bpm; p < 0.01), reflecting downregulation of autonomic pre-sleep arousal, relative to no-manipulation. HR continued to be lower during sleep, and participants had fewer awakenings and sleep stage transitions on the manipulation night relative to the control night (p < 0.05). The manipulation did not affect sleep onset latency or other PSG parameters. Overall, this novel behavioral approach targeting the falling asleep process emphasizes the importance of pre-sleep hyperarousal as a potential target for improving sleep and nocturnal autonomic function during sleep in insomnia.

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Acknowledgements

We would like to thank Justin Greco, Lena Kardos, David Dresser and Sarah Inkelis, for their effort in the data collection process.

Funding

This study was funded by the National Institutes of Health (NIH), Grant HL103688 (FCB).

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Authors and Affiliations

  1. Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025, USA

    Massimiliano de Zambotti, Stephanie Claudatos, Ian M. Colrain & Fiona C. Baker

  2. Center for Vision Technologies, SRI International, Princeton, NJ, USA

    Mikhail Sizintsev

  3. Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy

    Giacinto Barresi

  4. Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia

    Ian M. Colrain

  5. Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa

    Fiona C. Baker

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  1. Massimiliano de Zambotti
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  2. Mikhail Sizintsev
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  3. Stephanie Claudatos
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  4. Giacinto Barresi
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  5. Ian M. Colrain
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Correspondence to Massimiliano de Zambotti.

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Conflict of interests

Massimiliano de Zambotti, Fiona C. Baker, and Ian M. Colrain have received research funding unrelated to this work from Fitbit Inc., Ebb Therapeutics Inc., and International Flavors & Fragrances Inc. Mikhail Sizintsev, Stephanie Claudatos and Giacinto Barresi declared no conflict of interest.

Human and animal rights and informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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de Zambotti, M., Sizintsev, M., Claudatos, S. et al. Reducing bedtime physiological arousal levels using immersive audio-visual respiratory bio-feedback: a pilot study in women with insomnia symptoms. J Behav Med 42, 973–983 (2019). https://doi.org/10.1007/s10865-019-00020-9

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