The Application Research Of Sympathetic Skin Response And R-R Interval Variation In Patients With Insomnia

Object: To explore the value of Sympathetic skin response and R-R interval variation in autonomic nerve function tests of insomnia.Methods: As a retrospective study,we chose the patients who met the inclusion criteria of insomnia,and matched the healthy volunteers of age and gender.All the subjects were assessed by Sympathetic skin response(SSR)、R-R interval variation(RRIV)、Pittsburgh sleep quality index(PSQI)and Hospital Anxiety and Depression Scale(HADS).1.Participants50 outpatients(male: n= 22,female :n=28)diagnosed as insomnia using the(International classification of sleep disorders second Edition,ICSD-2)criteria were chosen.Judge by the doctors of neurology clinic、neurology ward and psychological clinic of huangshan city hospital from Sept.2014 to Jan.2016.And 30 healthy volunteers of age and gender matched.2.Statistics Data analysis using spss22.0 statistical software,compare the test results of SSR and RRIV between insomnia group and the control group.Independent-sample T test was used to compare the difference between the two groups of SSR and RRIV parameters.Spearman Correlation analysis was used to analyze the correlation between SSR、RRIV and HADS 、PSQI 、Course of insomnia.Pearson Correlation analysis was used to analyze the correlation between anxiety and depression scores,anxiety and PSQI scores,depression and PSQI scores.One-way analysis of variance was used to analyze the differences of anxiety group,depression group,anxiety-depression group and simple insomnia group.Results:1.Compared with the control group,The latency of the upper and lower limb SSR of insomnia group was significantly longer,RRIVD、RRIVR、RRIVD-R and RRIVD:R were significantly lower(P<0.05).Declined of amplitude of upper and lower limb SSR in insomnia has no significant statistical difference(P>0.05).2.A positive correlation was showed between PSQI score and the latency of the lower limb SSR(P < 0.05).Anxiety and depression scores were showed a positive correlation with the latency of the upper limb SSR,and the correlation coefficient is0.48(P=0.002).Depression scores were also showed a positive correlation with the latency of the upper limb SSR(P < 0.05).At same time depression scores were presented a negative correlation with the amplitude of upper limb SSR and RRIVD(P<0.05).There were no correlation between the Course of insomnia and the parameters of SSR and RRIV,and no correlation between the HADS and PSQI scores(P>0.05).3.The results of one-way analysis of variance showed,that there were no difference of parameters of SSR and RRIV among anxiety group 、 depression group 、anxiety-depression group and Simple insomnia group(P>0.05).Conclusions1.Compared with the control group,the latency of SSR is prolonged and RRIV is declined,which means the sympathetic nerve and vague nerve are damaged in patients with insomnia.SSR together with RRIV is an objective and effective method to detect the autonomic nerve dysfunction in insomnia.2.Compared with the control group,the decline of amplitude of SSR has no significant statistical difference.3.The latency of upper limb prolong extend in insomnia with emotional disorders.The more severity of depression the more decline of RRIVD.4.The severity of insomnia is positive related to the latency of the lower limb SSR.5.There were no difference of parameters of SSR and RRIV between the different group of patients with insomnia(anxiety、depression、anxiety-depression and Simple insomnia).6.The scores of sleep quality and sleep disorders in PSQI were related to dysfunction of Sympathetic nerve,and the scores of sleep disorders in PSQI were related to dysfunction of vague nerve in the patients with insomnia.