Abstract: Objective To investigate the effect of heart rate variability (HRV) biofeedback training on patients with three types of insomnia disorder. Methods From June, 2016 to March, 2017, 17 patients in simple insomnia group, 19 patients in insomnia with anxiety group, and 19 patients in insomnia with depression group were included. All the patients received HRV biofeedback training and same medication (zolpidem tartrate, 10 mg every night). They were assessed with Pittsburgh Sleep Quality Index (PSQI), Symptom Checklist 90 (SCL-90), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and HRV parameters were tracked before and after training. Results After training, the scores of PSQI, SCL-90, HAMA , HAMD and the ratio of low frequency (LF) and high frequency (HF) (LF/HF) decreased in all groups (t>1.446, P<0.05). There was significant difference in PSQI among three groups (F=3.537, P=0.038). The D-values of the PSQI score and LF/HF before and after training were more in the insomnia with anxiety group and the insomnia with depression group than in the simple insomnia group (P<0.05), however, no significant difference was observed between the insomnia with anxiety group and the insomnia with depression group (P>0.05). Conclusion HRV biofeedback training could improve the symptoms of patients with three types of insomnia disorder, especially for those with anxiety or depression.

Key words: heart rate variability, biofeedback, insomnia, anxiety, depression