ArticleSleep2021
Autonomic dysregulation and sleep homeostasis in insomnia.
Article in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 53 citations in OpenAlex.
- Transcutaneous auricular vagal nerve stimulation improves functional dyspepsia with sleep disturbance via enhanced vagal activity: a randomized controlled trial.International journal of surgery (London, England) · 2026Trial
- Towards an understanding of disturbed sleep phenotypes after traumatic spinal cord injury.Journal of rehabilitation medicine · 2026Observational
- Physical factor therapies for insomnia: a narrative review of mechanisms, clinical evidence, and phenotype-guided applications.Frontiers in psychiatry · 2026Review
- Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences.Medical sciences (Basel, Switzerland) · 2025Article
- Modulation of brain oscillations by continuous theta burst stimulation in patients with insomnia.Translational psychiatry · 2025Article
- A continuous approach to explain insomnia and subjective-objective sleep discrepancy.Communications biology · 2025Article
- Differential diagnosis of orthostatic dizziness with persistent postural-perceptual dizziness and its underlying mechanisms.Frontiers in neurology · 2025Review
- From Needles to Photons: Clinical Efficacy, Safety, and Mechanistic Insights of Laser Acupuncture in Insomnia Management.Nature and science of sleep · 2025Review
- Efficacy and safety of auricular acupressure on reduction of estazolam in patients with insomnia: a study protocol for a three-arm, blinded randomized controlled trial.BMC complementary medicine and therapies · 2024Article
- Article
- Daytime Sleepiness, Apnea, Neuroimaging Correlates and Cortisol Dysregulation in a Memory Clinic Cohort.The journal of prevention of Alzheimer's disease · 2024Article
- Association Between Sleep Reactivity, Pre-Sleep Arousal State, and Neuroendocrine Hormones in Patients with Chronic Insomnia Disorder.Nature and science of sleep · 2024Article
- Review
- Beyond the symptom: the biology of fatigue.Sleep · 2023Review
- Article
- Orexin, Sleep, Sympathetic Neural Activity, and Cardiovascular Function.Hypertension (Dallas, Tex. : 1979) · 2022Review
- Effect of Cognitive-Behavioral Therapy on Nocturnal Autonomic Activity in Patients with Fibromyalgia: A Preliminary Study.Brain sciences · 2022Article
- Temporal relations between peripheral and central arousals in good and poor sleepers.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Sympathetic neural responses to sleep disorders and insufficiencies.American journal of physiology. Heart and circulatory physiology · 2022Review
- Nightmare content during the COVID-19 pandemic: Influence of COVID-related stress and sleep disruption in the United States.Journal of sleep research · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
objectivesInsomnia is common in older adults, and is associated with poor health, including cognitive impairment and cardio-metabolic disease. Although the mechanisms linking insomnia with these comorbidities remain unclear, age-related changes in sleep and autonomic nervous system (ANS) regulation might represent a shared mechanistic pathway. In this study, we assessed the relationship between ANS activity with indices of objective and subjective sleep quality in older adults with insomnia.
methodsForty-three adults with chronic insomnia and 16 age-matched healthy sleeper controls were studied. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), objective sleep quality by electroencephalogram spectral components derived from polysomnography, and ANS activity by measuring 24-h plasma cortisol and norepinephrine (NE).
resultsSleep cycle analysis displayed lower slow oscillatory (SO: 0.5-1.25 Hz) activity in the first cycle in insomnia compared to controls. In insomnia, 24-h cortisol levels were higher and 24-h NE levels were lower than controls. In controls, but not in insomnia, there was a significant interaction between NE level during wake and SO activity levels across the sleep cycles, such that in controls but not in insomnia, NE level during wake was positively associated with the amount of SO activity in the first cycle. In insomnia, lower 24-h NE level and SO activity in the first sleep cycle were associated with poorer subjective sleep quality.
conclusionDysregulation of autonomic activity may be an underlying mechanism that links objective and subjective measures of sleep quality in older adults with insomnia, and potentially contribute to adverse health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.