The exploratory power of sleep effort, dysfunctional beliefs and arousal for insomnia severity and polysomnography-determined sleep
The exploratory power of sleep effort, dysfunctional beliefs and arousal for insomnia severity and polysomnography-determined sleep
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DOI：
10.1111/jsr.12293
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发表时间：
2015-08-01
影响因子：
4.4
通讯作者：
Spiegelhalder, Kai
中科院分区：
文献类型：
--
作者：
Hertenstein, Elisabeth;Nissen, Christoph;Spiegelhalder, Kai
主观睡眠感知和多导睡眠图（PSG）确定的睡眠之间的差异是普遍的，特别是在原发性失眠患者中，这表明这两种措施是部分独立的。为了确定个性化治疗策略，了解影响主观睡眠和PSG确定的睡眠的潜在不同机制非常重要。本研究的目的是调查失眠模型的三个主要组成部分，即睡眠努力、关于睡眠的功能失调的信念和态度以及前觉醒，在多大程度上与主观失眠严重程度和PSG确定的睡眠相关。对47例符合DSM-IV诊断标准的原发性失眠症患者和52例正常睡眠者进行24个夜晚的多导睡眠描记（PSG），并完成格拉斯哥睡眠努力量表、睡眠障碍信念和态度量表、睡眠前觉醒量表和失眠严重程度指数。进行回归分析以调查三个预测因子对主观失眠严重程度和PSG确定的总睡眠时间的影响。所有的分析都调整了年龄，性别，抑郁症状和组状态。结果表明，主观失眠严重程度与睡眠努力呈正相关。PSG测定的总睡眠时间与躯体预觉醒和功能失调的睡眠信念和态度呈负相关。这种结果模式为前瞻性研究提供了可检验的假设，这些研究涉及不同的认知和躯体变量对主观失眠严重程度和PSG确定的总睡眠时间的影响。
Differences between subjective sleep perception and sleep determined by polysomnography (PSG) are prevalent, particularly in patients with primary insomnia, indicating that the two measures are partially independent. To identify individualized treatment strategies, it is important to understand the potentially different mechanisms influencing subjective and PSG-determined sleep. The aim of this study was to investigate to what extent three major components of insomnia models, i.e. sleep effort, dysfunctional beliefs and attitudes about sleep, and presleep arousal, are associated with subjective insomnia severity and PSG- determined sleep. A sample of 47 patients with primary insomnia according to DSM-IV criteria and 52 good sleeper controls underwent 2nights of PSG and completed the Glasgow Sleep Effort Scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale, the Pre-Sleep Arousal Scale and the Insomnia Severity Index. Regression analyses were conducted to investigate the impact of the three predictors on subjective insomnia severity and PSG- determined total sleep time. All analyses were adjusted for age, gender, depressive symptoms and group status. The results showed that subjective insomnia severity was associated positively with sleep effort. PSG-determined total sleep time was associated negatively with somatic presleep arousal and dysfunctional beliefs and attitudes about sleep. This pattern of results provides testable hypotheses for prospective studies on the impact of distinct cognitive and somatic variables on subjective insomnia severity and PSG-determined total sleep time.