Chronic Stress is Prospectively Associated with Sleep in Midlife Women: The SWAN Sleep Study
Chronic Stress is Prospectively Associated with Sleep in Midlife Women: The SWAN Sleep Study
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DOI：
10.5665/sleep.5066
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发表时间：
2015-10-01
期刊：
影响因子：
5.6
通讯作者：
Buysse, Daniel J.
中科院分区：
文献类型：
--
作者：
Hall, Martica H.;Casement, Melynda D.;Buysse, Daniel J.
研究目的：评估在9年的时间内测量的令人沮丧的生活事件水平是否前瞻性地预测中年妇女的主观和客观睡眠结果。设计：前瞻性队列研究。设置：美国的四个地点。参与者：330名妇女（46-57岁）参加了全国妇女健康研究（SWAN）睡眠研究。干预措施：N/A。测量和结果：每年对扰乱生活事件进行评估，持续9年。应用于生活事件数据的轨迹分析定量地确定了三个不同的慢性压力组：低压力，中等压力和高压力。在研究的第九年，通过自我报告和家庭多导睡眠图（PSG）评估睡眠。多变量分析测试了慢性压力组和睡眠之间的前瞻性关联，调整了种族，基线睡眠投诉，婚姻状况，体重指数，抑郁症状和睡眠研究时的急性生活事件。高慢性压力的女性主观睡眠质量较低，更有可能报告失眠，并且相对于低至中度慢性压力的女性，PSG评估的睡眠后觉醒（WASO）增加。慢性压力组对WASO的影响持续在子样本的参与者没有基线sleep complaints.Conclusions：慢性压力与中年妇女的睡眠障碍，即使在调整急性压力源的时间睡眠研究和其他已知的干扰睡眠的因素。这些结果与当前强调压力源随着时间的推移对健康的累积影响的压力模型一致。
Study Objectives: Evaluate whether levels of upsetting life events measured over a 9-y period prospectively predict subjective and objective sleep outcomes in midlife women.Design: Prospective cohort study.Setting: Four sites across the United States.Participants: 330 women (46-57 y of age) enrolled in the Study of Women's Health Across the Nation (SWAN) Sleep Study.Interventions: N/A.Measurements and Results: Upsetting life events were assessed annually for up to 9 y. Trajectory analysis applied to life events data quantitatively identified three distinct chronic stress groups: low stress, moderate stress, and high stress. Sleep was assessed by self-report and in-home polysomnography (PSG) during the ninth year of the study. Multivariate analyses tested the prospective association between chronic stress group and sleep, adjusting for race, baseline sleep complaints, marital status, body mass index, symptoms of depression, and acute life events at the time of the Sleep Study. Women characterized by high chronic stress had lower subjective sleep quality, were more likely to report insomnia, and exhibited increased PSG-assessed wake after sleep onset (WASO) relative to women with low to moderate chronic stress profiles. The effect of chronic stress group on WASO persisted in the subsample of participants without baseline sleep complaints.Conclusions: Chronic stress is prospectively associated with sleep disturbance in midlife women, even after adjusting for acute stressors at the time of the sleep study and other factors known to disrupt sleep. These results are consistent with current models of stress that emphasize the cumulative effect of stressors on health over time.