Ceiling and floor effects in sleep research.
Ceiling and floor effects in sleep research.
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睡眠研究中的天花板和地板效应。
DOI：
10.1053/smrv.2001.0239
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发表时间：
2003
影响因子：
10.5
通讯作者：
Youngstedt,ShawnD
中科院分区：
文献类型：
--
作者：
Youngstedt,ShawnD
天花板和地板效应决定了促进睡眠的刺激的效果应该与刺激前睡眠损害的程度成正比。本文综述了多导睡眠图研究中涉及催眠药物和运动的CF效应。在两篇文献中都评估了安慰剂/基线睡眠水平与催眠或运动治疗后睡眠变化的相关性。Cf通过比较催眠药和运动的促进睡眠效果，在ANCOVA对照这些刺激物的研究中报告的显著基线差异后，进一步解决了这些影响。安慰剂基线水平与催眠和运动刺激后的睡眠变化之间存在显著的相关性。事实上，在催眠治疗后睡眠潜伏期(SOL)、入睡后觉醒(WASO)和总睡眠时间(TST)的改善方面，大约60%的差异与基线水平的差异有关。ANCOVA显示，与运动相比，催眠药后SOL和WASO的下降幅度更大。然而，两种刺激对TST没有显著差异，运动引起的慢波睡眠显著增加。当安眠药和锻炼之间的比较仅限于睡眠良好的人时，也发现了类似的结果。研究结果显示，对于安眠药和运动的睡眠反应，CF有很强的影响，因此有必要对睡眠质量较差的患者进行比较。
Ceiling and floor effects dictate that the efficacy of sleep-promoting stimuli should be proportional to the degree of pre-stimulus sleep impairment. This review addressed CF effects in polysomnographic research involving hypnotic drugs and exercise. Correlations of placebo/baseline levels of sleep with changes in sleep following hypnotic or exercise treatment were assessed across both literatures. CF effects were further addressed by comparing sleep-promoting effects of hypnotics vs exercise, after ANCOVA control for substantial baseline differences reported in studies of these stimuli. Significant correlations between placebo-baseline levels and sleep changes were observed following both hypnotic and exercise stimuli. Indeed, approximately 60% of the variance in improvement in sleep latency (SOL), wakefulness after sleep onset (WASO) and total sleep time (TST) following hypnotic treatment was associated with differences in baseline levels. ANCOVAs revealed significantly greater decreases in SOL and WASO following hypnotics compared with exercise. However, no significant difference between stimuli was found for TST, and exercise elicited a significantly greater increase in slow wave sleep. Similar results were found when a comparison between hypnotics and exercise was limited to good sleepers. The results show powerful CF influences on sleep responses to hypnotics and exercise and suggest a need for comparing these treatments in poor sleepers.