Study On Supine-to-standing Cerebral Blood Flow In Patients With Insomnia

Background:Insomnia,the most common sleep disorder,is a subjective experience of dissatisfaction with the quality or quantity of sleep that affects daily social functioning.As a common disease in modern society,the incidence of insomnia is increasing day by day.According to the survey,33% of Americans and 4% to 22% of Europeans suffer from insomnia,while the incidence of insomnia in China is as high as 10% to20%.There are many causes of insomnia and studies have suggested that all types of insomnia are closely related to depression and anxiety.Symptoms of anxiety and depression are also risk factors for insomnia in a variety of neurological disorders.Studies have found that patients with anxiety and depression have differences in cerebral blood flow regulation after postural changes,which reflects the impaired cerebral blood flow regulation ability of patients with anxiety and depression.Objective:To explore the supine-to-stand cerebral blood flow in patients with insomnia.Methods:The study included 160 patients diagnosed with insomnia from May 2015 to August 2018 in the sleep clinic of the First Hospital of Jilin University.Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Depression Rating Scale(HAMD)were evaluated.At the same time,healthy volunteers matched with age and gender were selected as the control group.Continuous supine-to-stand cerebral blood flow were detected,and the relevant clinical data were collected.Cerebral blood flow velocity,systolic blood pressure,diastolic blood pressure,heart rate(HR),pulsatility index(PI),(resistance index)RI and other indicators were analyzed between each group.The data were analyzed using statistical methods.Results:The difference between supine-to-stand cerebral blood flow in the insomnia group was significantly different than the control group,and the "w" wave disappeared in some patients.There was no significant difference in systolic blood pressure,diastolic blood pressure,HR,PI and RI between the insomnia group and the healthy control group.The severity of insomnia is positively related to the severity of anxiety and depression.The relationship between clinical factors and cerebral blood flow parameters in supine position was analyzed by single factor and multiple factor regression models.We found that: age,gender,large difference of cerebral blood flow in supine position,PI,RI and family history of insomnia may be correlated with insomnia.Conclusion:Patients with insomnia have impaired autonomic nerve function,and the difference of supine-to-stand cerebral blood flow is greater than the control group.Clinical insomnia patients with anxiety and depression;The severity of insomnia is positively correlated with the severity of anxiety and depression.Age,sex,difference between supine and stand cerebral blood flow speed,pulse index,resistance index and family history of insomnia were relevant to insomnia.Age,sex,intracerebral blood flow difference,PI,RI,and family history of insomnia may be related to insomnia.