Insomnia with physiological hyperarousal is associated with lower weight: a novel finding and its clinical implications

Previous studies on the association of insomnia with body mass index (BMI) have been controversial. Physiological hyperarousal, the key pathological mechanism of insomnia, may be an important reason for different findings. We explored whether insomnia with physiological hyperarousal measured by the multiple sleep latency test (MSLT) is associated with body-weight differences. A total of 185 normal sleepers and 440 insomniacs were included in this study. Insomnia was defined by standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent one night of laboratory polysomnography followed by a standard MSLT. We used the median MSLT value (i.e., ≥14 min) to define physiological hyperarousal. BMI was based on measured height (cm) and weight (kg) during the subjects’ sleep laboratory visit. BMI > 25 kg/m2 was defined as overweight, while BMI < 18.5 kg/m2 was defined as underweight. After controlling for confounders, the odds of lower weight rather than overweight were significantly increased among insomnia patients with increased MSLT: insomnia with MSLT 14–17 min and MSLT > 17 min increased the odds of lower weight by approximately 89% (OR = 1.89, 95% CI 1.00–4.85) and 273% (OR = 3.73, 95% CI 1.51–9.22) compared with normal sleepers, respectively. In contrast, insomnia in patients with MSLT 11–14 min and 8–11 min was not different from normal sleepers in terms of body weight. Insomnia associated with physiological hyperarousal, the most severe phenotype of chronic insomnia, is associated with higher odds of lower weight and underweight compared with normal sleepers. This is a novel finding consistent with previous physiologic data and has significant clinical implications.

Vocalisation and physiological hyperarousal in infant-caregiver dyads where the caregiver has elevated anxiety

Co-regulation of physiological arousal within the caregiver-child dyad precedes later self-regulation within the individual. Despite the importance of unimpaired self-regulatory development for later adjustment outcomes, little is understood about how early co-regulatory processes can become dysregulated during early life. Aspects of caregiver behaviour, such as patterns of anxious speech, may be one factor influencing infant arousal dysregulation. We made day-long, naturalistic biobehavioural recordings in home settings in caregiver-infant dyads using wearable autonomic devices and miniature microphones. We examined the association between arousal, vocalisation intensity and caregiver anxiety. Moments of high physiological arousal in infants were more likely to be accompanied by high caregiver arousal when caregivers had high self-reported trait anxiety. Anxious caregivers were more likely to vocalise intensely at states of high arousal, and produce intense vocalisations that occurred in clusters. High intensity vocalisations were associated with more sustained increases in autonomic arousal for both anxious caregivers and their infants. Caregiver vocal behaviour differs in anxious parents, co-occurs with dyadic arousal dysregulation and could contribute to physiological arousal transmission. Implications for caregiver vocalisation as an intervention target are discussed.

326 Comparison of Psychological and Physiological Features Between Insomnia Patients with Short and Normal Objective Sleep Duration

Introduction Objective sleep duration has been suggested to be a novel biomarker in the phenotyping of insomnia (Vgontzas & Fernandez-Mendoza, 2013). It was hypothesized that insomnia phenotype with PSG-defined short sleep duration (&lt; 6 hours) is associated with physiological hyperarousal, while the phenotype with normal sleep duration (≥ 6 hours), is associated with anxious-ruminative psychological profile and poor resources for coping with stress. The aim of this study was to assess whether these two insomnia phenotypes differ in terms of self-reported psychological and physiological features. Methods A total 45 (mean age=36.6, female=76%) insomnia patients underwent a polysomnographic evaluation, completed several self-rating scales (include ISI, BAI, BDI, FIRST, DBAS, and PSAS), and were split into two groups base on their objective sleep duration (cut-off 6 hours). Results When compared to the short sleep group using independent sample t-test, the normal sleep group showed a significant higher mean score on FIRST (t= -2.13; p&lt; .05). The short sleep group showed non-significant trends to have higher mean scores on BDI and BAI. The scores on the other scales showed no significant differences between the two groups. The FIRST score correlated positively with the score of DBAS (r= 0.32; p&lt; .05) and the total (r= 0.36; p&lt; .05) and cognitive-subscale scores (r= 0.41; p&lt; .01) on PSAS. The BAI score correlated positively with the score of the total (r= 0.53; p&lt; .001) and somatic subscale (r= 0.59; p&lt; .001) on PSAS. Conclusion These results support the hypotheses that the normal sleep phenotype tends to be more vulnerable to the impact of stress, especially on sleep, due to pre-sleep cognitive hyperarousal. Since the BAI scale contains more items regarding physiological symptoms of anxiety disorders, the tendency of higher BAI score in short sleep group may indicate that the short sleep phenotype has higher physiological arousal, which supports the phenotyping model proposed by Vgontzas and Fernandez-Mandoza. Support (if any):

The Test Anxiety Measure for College Students-Short Form: Development and Examination of Its Psychometric Properties

A short form of the 43-item Test Anxiety Measure for College Students (TAM-C) was developed in the present study. The TAM-C consists of six (social concerns, cognitive interference, worry, physiological hyperarousal, task irrelevant behaviors, and facilitating anxiety) scales. Twenty-four items from the TAM-C were selected for the short form. Single-group confirmatory factor analyses (CFAs) and correlational analyses were conducted with the responses of 728 U.S. college students to the TAM-C Short Form. Results of the single-group CFAs supported a six-factor model for the TAM-C Short Form. Concurrent and convergent validity evidence was found for the TAM-C Short Form scores. Overall, the findings suggest the TAM-C Short Form is an economical measure with unique features to assess test and facilitating anxiety in the college student population.

Evaluation of a Multi-Phase Trauma-Focused Intervention with Latino Youth

This pilot study examined the effectiveness of a multi-phase trauma-informed intervention with 24 trauma-exposed Latino youth. Treatment included a somatic-based intervention to target physiological hyperarousal symptoms and a sensory/cognitive-based trauma-focused intervention targeting stabilization of the trauma experience. Twenty-four participants completed several measures for mental health symptomatology and psychosocial functioning at baseline, at the conclusion of treatment, and at 3-month follow-up. Results of paired sample t-test analyses showed significant improvements in scores on measures for trauma, anxiety, depression, psychosocial functioning, and emotional dysregulation following 12 weeks of treatment when compared to baseline. Improvements were maintained at 3-month follow-up. This community-based intervention shows promise in helping Latino children who have experienced trauma. Research using randomized controlled designs with larger samples is suggested to further test the efficacy of this intervention.

The Test Anxiety Measure for College Students: Examination of Its Psychometric Properties Using an Online Survey With a Canadian Sample

The psychometric properties of a new multidimensional measure of test anxiety, the Test Anxiety Measure for College Students (TAM-C), based on theory and current research were examined in a sample of 312 Canadian college students online. The TAM-C consists of a Facilitating Anxiety scale and five test anxiety (Cognitive Interference, Physiological Hyperarousal, Social Concerns, Task Irrelevant Behaviors, and Worry) scales. Results of confirmatory factor analyses validated the TAM-C six-factor structure. In addition, composite reliabilities were reported to be adequate. Furthermore, convergent and discriminant evidence of validity was found for the TAM-C scores. These findings are the first to be reported on the psychometric properties of the TAM-C scores outside the United States. Although additional research is needed with the TAM-C, it has the potential to become a useful measure to Canadian mental health professionals in their work with test-anxious college students.