Adverse childhood experiences associated with sleep in primary insomnia
Adverse childhood experiences associated with sleep in primary insomnia
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DOI：
10.1111/j.1365-2869.2007.00608.x
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发表时间：
2007-09-01
影响因子：
4.4
通讯作者：
Schwander, Juerg
中科院分区：
文献类型：
--
作者：
Bader, Klaus;Schaefer, Valerie;Schwander, Juerg
目的是探索自我报告的童年不良经历（ACE）与患有原发性失眠症的成年人睡眠之间的联系，并检查睡眠前压力对这种关系的影响。对59例21 ~ 55岁的原发性失眠症患者进行儿童创伤问卷调查（CTQ），并根据得分分为中度/重度和低/无ACE报告两组。参与者在睡眠实验室连续呆了三个晚上，以记录多导睡眠图和活动图睡眠参数。在第二个或第三个晚上睡觉前，通过激活负面的自传体记忆来实施压力诱导技术。结果显示，46%的失眠症患者报告有中重度ACE。与ACE低报告或无报告的患者相比，该组表现出明显更多的觉醒次数和更多的运动唤醒。动图数据还显示，ace高组的睡眠受到更多干扰，夜间活动增加。另一方面，在应激状态方面没有发现特定的组间差异。研究结果支持这样一种假设，即有可能在童年和青春期经历过严重虐待的原发性失眠症患者中确定一个亚组。这个亚组似乎在几个睡眠参数上有所不同，这表明与低ACE或无ACE报告的原发性失眠症患者相比，他们的睡眠更受干扰。关于令人睡眠不安的夜间唤醒模式，高ACE患者与创伤受害者以及创伤后应激障碍患者之间的相似之处表明了这一点。
The objectives were to explore the association between self-reported adverse childhood experiences (ACE) and sleep in adults suffering from primary insomnia and to examine the impact of presleep stress on this relationship. Fifty-nine patients with primary insomnia, aged 21-55 years, were administered the Childhood Trauma Questionnaire (CTQ) and then divided into two groups according to the achieved scores: with moderate/severe or low/no reports of ACE. The participants spent three consecutive nights in the sleep laboratory in order to record polysomnographic and actigraphic sleep parameters. A stress induction technique was administered by activating negative autobiographical memories immediately before sleep in the second or third night. Results show that 46% of the insomniac patients reported moderate to severe ACE. This group exhibited a significantly greater number of awakenings and more movement arousals compared to patients with low or no reports of ACE. Actigraphic data also indicated more disturbed sleep and increased nocturnal activity for the high-ACE group. On the other hand, no specific group differences were found with regard to stress condition. The results support the assumption that it is possible to identify a subgroup among patients with primary insomnia who has experienced severe maltreatment in childhood and adolescence. This subgroup appears to differ in several sleep parameters, indicating a more disturbed sleep compared to primary insomniacs with low or no reports of ACE. With regard to sleep-disturbing nightly patterns of arousal, parallels between individuals with high ACE and trauma victims as well as post-traumatic stress disorder-patients suggest themselves.