Role of stress, arousal, and coping skills in primary insomnia
Role of stress, arousal, and coping skills in primary insomnia
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DOI：
10.1097/01.psy.0000030391.09558.a3
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发表时间：
2003-03-01
影响因子：
3.3
通讯作者：
Ivers, H
中科院分区：
文献类型：
--
作者：
Morin, CM;Rodrigue, S;Ivers, H
目的：虽然压力通常被认为是导致睡眠障碍的原因，但很少有研究记录了压力性生活事件在原发性失眠中的作用。本研究探讨了压力和应对技能的关系，以及前觉醒的潜在中介作用，睡眠良好者和失眠患者的睡眠模式。方法：样本包括67名参与者（38名女性，29名男性;平均年龄，39.6岁），40名失眠者和27名睡眠良好者。受试者连续21天完成了对压力事件、睡前觉醒和睡眠的前瞻性每日测量。此外，他们还完成了几项关于抑郁、焦虑、压力性生活事件和应对技能的回顾性和全球性测量。结果：结果显示，睡眠差和睡眠好的人报告的轻微压力生活事件数量相等。然而，失眠症患者对日常轻微压力源的影响和主要负面生活事件的强度的评价都高于睡眠良好者。此外，失眠症患者认为他们的生活压力更大，更依赖于以情绪为导向的应对策略，并报告比良好的睡眠者更大的前觉醒。前瞻性的日常数据显示，白天的压力和夜间睡眠之间的显着关系，但前觉醒和应对技能发挥了重要的中介作用。结论：研究结果表明，压力源的评估和对压力事件缺乏控制的感觉，而不是压力事件本身的数量，增强了失眠的脆弱性。唤醒和应对技能在压力和睡眠之间起着重要的中介作用。这些结果的主要含义是，失眠的治疗应该包括旨在教授有效的压力评估和应对技能的临床方法。
Objective: Although stress is often presumed to cause sleep disturbances, little research has documented the role of stressful life events in primary insomnia. The present study examined the relationship of stress and coping skills, and the potential mediating role of presleep arousal, to sleep patterns in good sleepers and insomnia sufferers. Methods: The sample was composed of 67 participants (38 women, 29 men; mean age, 39.6 years), 40 individuals with insomnia and 27 good sleepers. Subjects completed prospective, daily measures of stressful events, presleep arousal, and sleep for 21 consecutive days. In addition, they completed several retrospective and global measures of depression, anxiety, stressful life events, and coping skills. Results: The results showed that poor and good sleepers reported equivalent numbers of minor stressful life events. However, insomniacs rated both the impact of daily minor stressors and the intensity of major negative life events higher than did good sleepers. In addition, insomniacs perceived their lives as more stressful, relied more on emotion-oriented coping strategies, and reported greater presleep arousal than good sleepers. Prospective daily data showed significant relationships between daytime stress and nighttime sleep, but presleep arousal and coping skills played an important mediating role. Conclusions: The findings suggest that the appraisal of stressors and the perceived lack of control over stressful events, rather than the number of stressful events per se, enhance the vulnerability to insomnia. Arousal and coping skills play an important mediating role between stress and sleep. The main implication of these results is that insomnia treatments should incorporate clinical methods designed to teach effective stress appraisal and coping skills.