Compromised cerebral autoregulation function in patients with chronic insomnia disorder

Objective To analyze the cerebral autoregulation capability in patients with chronic insomnia disorder (CID). Methods Sixty CID patients (54 with generalized anxiety disorder) and 40 healthy controls were enrolled in this study. Polysomnography was done in all the participants. Noninvasive continuous cerebral blood flow velocity of bilateral middle artery and arterial blood pressure were recorded simultaneously using transcranial Doppler and a servo-controlled plethysmograph. Transfer function analysis was used to derive the autoregulatory parameters, including phase difference and coherence function. Results The phase difference values of CID patients with generalized anxiety disorder were significantly lower than that of the healthy controls ((46.89±15.39)°vs (56.00±12.05)°, t=3.439, P=0.001). In the correlation analysis, we further found that there was no correlation among phase difference values and the score of Hospital Anxiety and Depression scale. Conclusions The dynamic cerebral autoregulation was compromised in CID patients with generalized anxiety disorder regardless of the degrees of anxiety and depression. Dynamic cerebral autoregulation may be a potential therapeutic target in improving neurological symptoms in patients with CID. Key words: Sleep initiation and maintenance disorders; Anxiety; Blood flow velocity; Ultrasonography, Doppler, transcranial