Pupil reflex may help identify hyperarousal in insomnia

CHARLOTTE, N.C. — Pupillary light reflex testing may hold potential in detecting a hyperarousal subtype of patients with insomnia, William Vaughn McCall, MD, said at the SLEEP 2022 meeting.

Cognitive behavior therapy is considered a first-line treatment for chronic insomnia; however, a hyperarousal subtype of patients may require pharmacotherapy, according to McCall, professor and Case Distinguished University Chair of Psychiatry and Health Behavior at the Medical College of Georgia.

McCall evaluated the use of the NeurOptics PLR-3000 Pupillometer in 40 community volunteers as a potential point-of-care test for use in people with insomnia.

According to McCall, people must sit in the dark for 10 to 20 minutes to get a stable measurement, and it takes 10 seconds to acquire data with the pupillometer, which provides an instantaneous display.

Participants also completed the Insomnia Severity Index (ISI). Sixteen scored greater than 4 on the ISI, which indicates modest insomnia, and 24 scored less than 4, which means no insomnia.

According to the study abstract, 62.5% of participants were women and 30% were non-white; the average age of the group was 26 years.

Pupillary light reflex testing showed relative arousal in participants with modest insomnia symptoms, which suggests the instrument has promise as a point-of-care test this subtype of patients with insomnia, McCall said.