Vulnerability to stress-related sleep disturbance and hyperarousal
Vulnerability to stress-related sleep disturbance and hyperarousal
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DOI：
10.1093/sleep/27.2.285
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发表时间：
2004-03-15
期刊：
影响因子：
5.6
通讯作者：
Roth, T
中科院分区：
文献类型：
--
作者：
Drake, C;Richardson, G;Roth, T
研究目的：确定存在一种假设的易受睡眠障碍和过度觉醒影响的特质。设计：在实验室的第一个晚上和随后的生理唤醒中，多导睡眠图评估睡眠对压力的反应。参与者：从基于人群的样本中抽取的104个人（46%为男性，平均年龄40.4±12.9岁）。干预措施：个体暴露在实验室的第一个晚上。测量和结果：参与者完成了一份李克特量表问卷，包括27个项目，评估睡眠障碍对常见压力情况的反应。因子分析技术确定了一个单一的9项因子，代表了“压力相关”睡眠障碍脆弱性的结构。得到的9项量表的信度很高（Cronbach's alpha = .83）。在福特失眠压力测试（FIRST，中位数分割）中得分较高的个体，睡眠效率较低（P = 0.001），并且在夜间多导睡眠仪的第一个晚上，进入第一阶段睡眠的潜伏期增加（P = 0.001）和持续睡眠（P = 0.002）。此外，与FIRST得分低的人相比，这些高分的人在多次睡眠潜伏期测试中表现出更高的睡眠潜伏期，这证明了他们的觉醒程度。重要的是，在控制了当前和过去的失眠症后，在夜间睡眠和白天觉醒方面，第一项得分高和低的个体之间的差异仍然很大。其他阶段的睡眠（第二阶段，慢波睡眠和快速眼动睡眠）在两组之间没有区别。结论：这些结果显示了FIRST分数与夜间多导睡眠图和多次睡眠潜伏期测试分数之间的关系，这有3个潜在的含义：(1)数据显示了一种与压力相关的睡眠障碍易感性相关的特征，这种特征表现在实验室的第一晚；(2)尽管这些人的睡眠受到了明显的干扰，但多重睡眠潜伏期测试的潜伏期升高支持了这些人的生理性高觉醒的概念，并提示他们可能易患慢性原发性失眠；(3)发现的易感性可能是与其他睡眠干扰因素相关的短暂睡眠障碍易感性的基础。
Study Objectives: To determine the presence of a hypothesized trait vulnerability to sleep disturbance and hyperarousal.Design: Polysomnographic assessment of sleep in response to stress during a first night in the laboratory and subsequent physiologic arousal.Participants: One hundred and four individuals (46% men, mean age 40.4 +/- 12.9 years) drawn from a population-based sample.Interventions: Individuals were exposed to a first night in the laboratory.Measurements and Results: Participants completed a Likert-scale questionnaire, consisting of 27 items, that assesses sleep disturbance in response to commonly experienced stressful situations. Factor analytic techniques identified a single 9-item factor that was representative of the construct of "stress-related" vulnerability to sleep disturbance. Reliability of the resulting 9-item scale was high (Cronbach's alpha = .83). Individuals with higher scores on this scale, the Ford Insomnia Response to Stress Test (FIRST, median split), had a lower sleep efficiency (P = .001), as well as an increased latency to stage 1 sleep (P = .001) and persistent sleep (P = .002) on the first night of nocturnal polysomnography. Moreover, these high-scoring individuals showed increased arousal as evidenced by an elevated sleep latency on the Multiple Sleep Latency Test compared to individuals with low FIRST scores. Importantly, after controlling for current and past insomnia, the differences between individuals scoring high and low on the FIRST in terms of nocturnal sleep and daytime arousal remained significant. Other stages of sleep (stage 2, slow-wave, and rapid eye movement sleep) were not different between the groups.Conclusions: These results showing a relationship between FIRST scores and nocturnal polysomnography and Multiple Sleep Latency Test scores have 3 potential implications: (1) the data demonstrate a characteristic that relates to vulnerability to stress-related sleep disturbance as manifested by a first night in the laboratory; (2) the elevated latencies on the Multiple Sleep Latency Test in these individuals, despite significantly disturbed sleep, support the notion of physiologic hyperarousal in these individuals and suggests they may be predisposed to developing chronic primary insomnia; and (3) the vulnerability identified may underlie vulnerability to transient sleep disturbance associated with other sleep-disruptive factors.