Sleep quality following hematopoietic stem cell transplantation: longitudinal trajectories and biobehavioral correlates
Sleep quality following hematopoietic stem cell transplantation: longitudinal trajectories and biobehavioral correlates
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DOI：
10.1038/bmt.2014.179
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发表时间：
2014-11-01
影响因子：
4.8
通讯作者：
Costanzo, E. S.
中科院分区：
文献类型：
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作者：
Nelson, A. M.;Coe, C. L.;Costanzo, E. S.
本研究检测了造血干细胞移植（HSCT）后睡眠质量的变化，并调查了与生物行为因素的相关性。接受HSCT治疗恶性血液病的个体（N = 228）在移植前和移植后1、3、6和12个月完成了睡眠质量和心理症状的测量。还评估了循环炎性细胞因子（IL-6、TNF-α）。移植后1个月睡眠质量最差，移植后3个月改善并保持相对稳定。然而，大约一半的参与者在移植后6个月和12个月继续经历严重的睡眠障碍。混合效应线性回归模型表明，抑郁和焦虑与睡眠质量较差有关，而心理健康与睡眠质量较好有关。较高的循环IL-6水平也与睡眠较差有关。受试者水平的固定效应模型表明，在个体参与者中，抑郁，焦虑和心理健康的变化与移植后时间效应协变后睡眠的相应变化相关。当抑郁和焦虑最严重，心理健康最低时，睡眠障碍最严重。研究结果表明，睡眠障碍是一个持续的问题，在一年后HSCT。患有抑郁症或焦虑症的患者以及炎症升高的患者可能特别有睡眠不佳的风险。
The present study examined changes in sleep quality following hematopoietic stem cell transplantation (HSCT) and investigated associations with biobehavioral factors. Individuals undergoing HSCT for hematologic malignancies (N = 228) completed measures of sleep quality and psychological symptoms pre-transplant and 1, 3, 6 and 12 months post transplant. Circulating inflammatory cytokines (IL-6, TNF-alpha) were also assessed. Sleep quality was poorest at 1 month post transplant, improving and remaining relatively stable after 3 months post transplant. However, approximately half of participants continued to experience significant sleep disturbance at 6 and 12 months post transplant. Mixed-effects linear regression models indicated that depression and anxiety were associated with poorer sleep quality, while psychological well-being was associated with better sleep. Higher circulating levels of IL-6 were also linked with poorer sleep. Subject-level fixed effects models demonstrated that among individual participants, changes in depression, anxiety and psychological well-being were associated with corresponding changes in sleep after covarying for the effects of time since transplant. Sleep disturbance was most severe when depression and anxiety were greatest and psychological well-being was lowest. Findings indicate that sleep disturbance is a persistent problem during the year following HSCT. Patients experiencing depression or anxiety and those with elevated inflammation may be at particular risk for poor sleep.