本研究探讨了患有共病失眠的癌症患者在标准和分级护理框架内，高频心率变异性 (HF-HRV) 和 HF-HRV 反应性是否会对失眠认知行为疗法 (CBT-I) 产生中等反应。 HF-HRV 等生物标志物可以预测对 CBT-I 的反应，这一发现可能会为患者在分级护理框架内分配到不同的治疗强度提供信息。177 名参与者（86.3% 为女性；Mage = 55.3，SD = 10.4）被随机分配接受分级护理或标准 CBT-I。 145 名参与者在治疗前休息和担心期间接受了 HRV 评估。使用失眠严重程度指数 (ISI) 和每日睡眠日记评估从治疗前到治疗后 12 个月随访的五个时间点的失眠症状。静息 HF-HRV 与治疗前睡眠效率和睡眠显着相关发病潜伏期但不是 ISI 分数。然而，静息 HF-HRV 并不能预测治疗和随访期间失眠的总体变化。同样，静息 HF-HRV 并不能差异预测标准组或分级护理组睡眠日记参数的变化。 HRV 反应性与横断面和纵向分析中的任何评估结果测量均无关。尽管静息 HF-HRV 与初始每日睡眠参数相关，但 HF-HRV 测量并不能显着预测对 CBT-I 的纵向反应。这些发现表明，HF-HRV 不能预测癌症患者对不同强度的 CBT-I 干预的治疗反应。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

This study examined whether high frequency heart-rate variability (HF-HRV) and HF-HRV reactivity to worry moderate response to cognitive behavioural therapy for insomnia (CBT-I) within both a standard and stepped-care framework among cancer patients with comorbid insomnia. Biomarkers such as HF-HRV may predict response to CBT-I, a finding which could potentially inform patient allocation to different treatment intensities within a stepped-care framework.177 participants (86.3 % female; Mage = 55.3, SD = 10.4) were randomized to receive either stepped-care or standard CBT-I. 145 participants had their HRV assessed at pre-treatment during a rest and worry period. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI) and daily sleep diary across five timepoints from pre-treatment to a 12-month post-treatment follow-up.Resting HF-HRV was significantly associated with pre-treatment sleep efficiency and sleep onset latency but not ISI score. However, resting HF-HRV did not predict overall changes in insomnia across treatment and follow-up. Similarly, resting HF-HRV did not differentially predict changes in sleep diary parameters across standard or stepped-care groups. HRV reactivity was not related to any of the assessed outcome measures in both cross-sectional and longitudinal analyses.Although resting HF-HRV was related to initial daily sleep parameters, HF-HRV measures did not significantly predict longitudinal responses to CBT-I. These findings suggest that HF-HRV does not predict treatment responsiveness to CBT-I interventions of different intensity in cancer patients.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.