The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia.
The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia.
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失眠的自然史：失眠早期发展过程中的易感因素、诱发因素、应对因素和持续因素
DOI：
10.1093/sleep/zsab095
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发表时间：
2021-09-13
期刊：
影响因子：
5.6
通讯作者：
Gardani M
中科院分区：
文献类型：
--
作者：
Ellis JG;Perlis ML;Espie CA;Grandner MA;Bastien CH;Barclay NL;Altena E;Gardani M
虽然关于慢性失眠者的易感因素、诱发因素、应对因素和维持因素已有大量文献，但在失眠的早期发展过程中对这些因素进行评估的研究却很少。本研究的目的是确定在急性失眠（AI）发作期间评估的每个领域（易感、诱发、应对和维持）的几个假设因素是否与其持续存在或恢复正常睡眠有关。参与者包括从普通公众中招募的140名急性失眠者和737名正常睡眠者。参与者完成了评估易感特征（人格特质、唤醒倾向和失眠易感性）、诱发事件和结果（生活事件、感知压力、焦虑和抑郁）、应对方式（思维控制策略和应对方式）以及维持因素（睡眠困扰、睡前唤醒、功能失调的信念和疲劳）的测量。此外，1个月后评估了失眠状况（从基线时的急性失眠到其持续存在或自然缓解[NR]）（n = 129）。在每个领域都观察到正常睡眠者和急性失眠者之间存在基线差异，年龄增长、开放性和尽责性较低、失眠严重程度较高、焦虑水平以及情感性睡眠困扰显著预测了急性失眠状况。此外，既往有失眠发作、抑郁评分较高以及情感性睡眠困扰评分较高显著预测了失眠的持续存在，而非自然缓解。研究结果结合失眠的概念化进行了讨论，以及这些发现如何影响预防性干预措施的设计，以避免从急性失眠向慢性失眠的转变。
While there is an extensive literature on predisposing, precipitating, coping, and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, precipitating, coping, and perpetuating), assessed during an episode of acute insomnia (AI), are related to its persistence or remission to normal sleep. Participants comprised n = 140 people with AI and n = 737 normal sleepers (NS) recruited from the general public. Participants completed measures assessing predisposing characteristics (personality traits, arousal predisposition, and insomnia vulnerability), precipitating events and outcomes (life events, perceived stress, anxiety, and depression), coping styles (thought control strategies and coping styles), and perpetuating factors (sleep preoccupation, pre-sleep arousal, dysfunctional beliefs, and fatigue). Additionally, insomnia status (from AI at baseline to its persistence or natural remission [NR]) was assessed 1 month later (n = 129). Baseline differences between NS and individuals with AI were observed in each domain with increasing age, lower openness to experience and conscientiousness, higher insomnia severity, levels of anxiety, and affective sleep preoccupation significantly predicting AI status. Further, a previous episode of insomnia, higher depression scores, and affective sleep preoccupation scores significantly predicted its persistence, as opposed to its NR. Results are discussed with reference to the conceptualization of insomnia and how the findings may influence the design of preventative interventions to circumvent the transition from acute to chronic insomnia.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
3.3
作者：
Boullin P;Ellwood C;Ellis JG
通讯作者：
Ellis JG
影响因子：
--
作者：
KLINK, ME;QUAN, SF;LEBOWITZ, MD
通讯作者：
LEBOWITZ, MD
影响因子：
4.8
作者：
Bastien, Celyne H.;Vallieres, Annie;Morin, Charles M.
通讯作者：
Morin, Charles M.
影响因子：
4.7
作者：
LeBlanc, Melanie;Beaulieu-Bonneau, Simon;Morin, Charles M.
通讯作者：
Morin, Charles M.