The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders.
The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders.
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DOI：
10.1111/jsr.12710
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发表时间：
2018-12
影响因子：
4.4
通讯作者：
Drake CL
中科院分区：
文献类型：
--
作者：
Kalmbach DA;Anderson JR;Drake CL
睡眠反应性是压力暴露扰乱睡眠的程度，导致难以入睡和保持睡眠。具有高反应性睡眠系统的人在压力下会经历睡眠的急剧恶化，而那些睡眠反应性低的人在压力下基本上不受干扰。研究表明，遗传、失眠家族史、女性性别和环境压力都会影响睡眠系统对压力的反应。进一步的研究已经确定了睡眠反应的神经生物学基础，包括皮质网络的破坏和自主神经系统和下丘脑-垂体-肾上腺轴的失调。睡眠反应性在过度时在病理学和临床上最相关，使得高睡眠反应性预测未来失眠障碍的风险，早期证据表明高睡眠反应性对应于严重失眠表型（睡眠发作失眠和短睡眠失眠）。高睡眠反应性也与轮班工作障碍、抑郁和焦虑的风险有关。重要的是，与压力相关的担忧和沉思可能会利用敏感的睡眠系统，从而增加睡眠反应的致病性。随着对睡眠反应性的成本效益评估的发展，我们现在可以确定未来失眠、轮班工作障碍和精神疾病风险的个体，从而确定预防干预的目标人群。鉴于具有高睡眠反应性的失眠症患者倾向于呈现严重的失眠表型，患者的睡眠反应性可以告知对不同治疗水平的分类。未来需要对睡眠反应性进行研究，以澄清其神经生物学，表征其与失眠和轮班工作障碍表型的长期前瞻性关联，并建立其对精神疾病和其他非睡眠障碍的预后价值。
Sleep reactivity is the trait-like degree to which stress exposure disrupts sleep, resulting in difficulty falling and staying asleep. Individuals with highly reactive sleep systems experience drastic deterioration of sleep when stressed, whereas those with low sleep reactivity proceed largely unperturbed during stress. Research shows that genetics, familial history of insomnia, female gender and environmental stress influence how the sleep system responds to stress. Further work has identified neurobiological underpinnings for sleep reactivity involving disrupted cortical networks and dysregulation in the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Sleep reactivity is most pathologically and clinically pertinent when in excess, such that high sleep reactivity predicts risk for future insomnia disorder, with early evidence suggesting high sleep reactivity corresponds to severe insomnia phenotypes (sleep onset insomnia and short sleep insomnia). High sleep reactivity is also linked to risk of shift-work disorder, depression and anxiety. Importantly, stress-related worry and rumination may exploit sensitive sleep systems, thereby augmenting the pathogenicity of sleep reactivity. With the development of cost-effective assessment of sleep reactivity, we can now identify individuals at risk of future insomnia, shift-work disorder and mental illness, thus identifying a target population for preventive intervention. Given that insomniacs with high sleep reactivity tend to present with severe insomnia phenotypes, patient sleep reactivity may inform triaging to different levels of treatment. Future research on sleep reactivity is needed to clarify its neurobiology, characterize its long-term prospective associations with insomnia and shift-work disorder phenotypes, and establish its prognostic value for mental illness and other non-sleep disorders.
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DOI：
10.1523/jneurosci.1809-08.2008
发表时间：
2008-10-01
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Cano G;Mochizuki T;Saper CB
通讯作者：
Saper CB
影响因子：
2.8
作者：
Basta, Maria;Chrousos, George P.;Vgontzas, Alexandros N.
通讯作者：
Vgontzas, Alexandros N.
影响因子：
4.4
作者：
Bastien, CH;Morin, C
通讯作者：
Morin, C
影响因子：
3.3
作者：
Bonnet, MH;Arand, DL
通讯作者：
Arand, DL
影响因子：
5.6
作者：
Bathgate, Christina J.;Edinger, Jack D.;Krystal, Andrew D.
通讯作者：
Krystal, Andrew D.