Sleep and Physiological Dysregulation: A Closer Look at Sleep Intraindividual Variability
Sleep and Physiological Dysregulation: A Closer Look at Sleep Intraindividual Variability
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DOI：
10.1093/sleep/zsx109
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发表时间：
2017-09-01
期刊：
影响因子：
5.6
通讯作者：
Wiley, Joshua F.
中科院分区：
文献类型：
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作者：
Bei, Bei;Seeman, Teresa E.;Wiley, Joshua F.
研究目的：多变的日常睡眠（即较高的个体差异；iv）与负面健康后果相关，但潜在的生理机制尚不清楚。本研究考察了睡眠时间、持续时间和质量的iv如何与生理失调相关，将昼夜皮质醇轨迹作为近端结果，将适应负荷（AL）作为多系统远端结果。方法：参与者是来自美国中年研究的436名成年人（m -年龄+/-标准差= 54.1 +/- 11.7,60.3%为女性）。采用7天活动描记法客观评价睡眠。通过唾液样本测量皮质醇的昼夜变化（每天4次，连续4天）。AL使用来自7个系统（炎症、下丘脑-垂体-肾上腺轴、代谢葡萄糖和脂质、心血管、副交感神经、交感神经）的23种生物标志物进行测量，采用经过验证的双因素模型。使用经过验证的贝叶斯模型估计睡眠iv的线性和二次效应。结果：控制协变量，更多可变睡眠时间（起床时间p = 0.04，就寝时间p = 0.097）和总睡眠时间（TST, p = 0.02），但不包括平均睡眠变量，与平缓的皮质醇日斜率相关。经年龄和性别调整后，更多可变的睡眠开始潜伏期和睡眠开始后醒来、较晚的平均就寝时间和较短的TST与较高的AL相关（p值< 0.05）；然而，在控制所有协变量后，只有较晚的平均就寝时间仍与较高的AL显著相关（p = 0.04）。结论：在一个成人社区样本中，更多的可变睡眠模式与钝化的皮质醇昼夜轨迹相关，但与更高的多系统生理失调无关。睡眠iv与整体健康之间的关系可能很复杂，包括多种生物心理社会决定因素，需要进一步研究。
Study Objectives: Variable daily sleep (ie, higher intraindividual variability; IIV) is associated with negative health consequences, but potential physiological mechanisms are poorly understood. This study examined how the IIV of sleep timing, duration, and quality is associated with physiological dysregulation, with diurnal cortisol trajectories as a proximal outcome and allostatic load (AL) as a multisystem distal outcome.Methods: Participants are 436 adults (M-age +/- standard deviation = 54.1 +/- 11.7, 60.3% women) from the Midlife in the United States study. Sleep was objectively assessed using 7-day actigraphy. Diurnal cortisol was measured via saliva samples (four/day for 4 consecutive days). AL was measured using 23 biomarkers from seven systems (inflammatory, hypothalamic-pituitary-adrenal axis, metabolic glucose and lipid, cardiovascular, parasympathetic, sympathetic) using a validated bifactor model. Linear and quadratic effects of sleep IIV were estimated using a validated Bayesian model.Results: Controlling for covariates, more variable sleep timing (p = .04 for risetime, p = .097 for bedtime) and total sleep time (TST; p =.02), but not mean sleep variables, were associated with flatter cortisol diurnal slope. More variable sleep onset latency and wake after sleep onset, later average bedtime, and shorter TST were associated with higher AL adjusting for age and sex (p-values < .05); after controlling for all covariates, however, only later mean bedtime remained significantly associated with higher AL (p = .04).Conclusions: In a community sample of adults, more variable sleep patterns were associated with blunted diurnal cortisol trajectories but not with higher multisystem physiological dysregulation. The associations between sleep IIV and overall health are likely complex, including multiple biopsychosocial determinants and require further investigation.