A NURSING STUDY OF PERIMENOPAUSAL INSOMNIA

失眠是最常见的睡眠障碍，患病率很高 在女性中。 睡眠不佳与日间功能有关 变化、寿命缩短、发病率增加、组织改变 恢复和免疫功能。 Incidence被认为是一个 复杂的非均质现象，有多种类型， 精神病理学或医学状况。 原发性失眠表现为 无论是否有睡眠障碍的客观证据， 与高环境压力事件相关， 认知/情感唤醒和躯体唤醒的过程， 与睡眠不相容的行为， 睡眠/觉醒模式不足。 然而，这些集群 描述亚型的因素尚未研究，特别是 中年女性的最佳选择 这种分类将有助于 预测适当的干预措施。 本研究的具体目的是：1）确定 有客观睡眠模式的失眠妇女比例 改变，2）比较失眠妇女与妇女谁报告良好 睡眠对认知/情绪唤醒、躯体唤醒 睡眠行为、终生睡眠质量、生活事件与更年期 状态，3）描述唤醒，睡眠行为， 终生睡眠质量、生活事件和围绝经期状态， 睡眠变量，并描述a）生活 事件和认知/情绪和躯体唤醒指标。 女性（n = 60），40 - 55岁，经历睡眠困难 至少3个月，在最近一段时间内开始或恶化 3年，谁属性一些白天的影响失眠，与 无身体或精神疾病史，近期或长期 轮班工作，药物滥用，或经历慢性疼痛将是 用SCL 90进行精神病理学筛查。 一 对照组（n = 30），年龄相仿，报告睡眠良好， 也被招募。 客观睡眠将通过标准监测 多导睡眠图和睡眠日记上的主观睡眠， POMS和Spielberger焦虑引起的认知/情感唤醒 清单，清醒时的躯体唤醒， 额肌肌电图、皮肤温度和皮肤的应激源 平均直肠温度，面部肌电图 以及尿中的儿茶酚胺和皮质醇。 睡眠行为和 终身睡眠将根据睡眠史进行测量， Norbeck Life Events调查的环境压力因素。

Insomnia is the most common disorder of sleep with high prevalence among women. Poor sleep is associated with daytime functional changes, diminished longevity, increased morbidity, altered tissue restitution, and immune function. Insomnia is considered to be a complex heterogeneous phenomenon with many types secondary to psychopathology or medical conditions. Primary insomnia manifests with or without objective evidence of sleep disorder and has been associated with high environmental stressful events, a high level of cognitive/emotional arousal and somatic arousal, learned behaviors that are incompatible with sleep and a propensity to inadequate sleep/wake patterns. However, the clusters of these factors that describe subtypes have not been studied, particularly in women in their middle years. Such categorization would help predict appropriate interventions. The specific aims of this study are to: 1) determine the proportion of insomniac women that have objective sleep pattern alterations, 2) compare insomniac women with women who report good sleep on factors of cognitive/emotional arousal, somatic arousal, sleep behaviors, lifetime sleep quality, life events and menopause status, 3) describe the relationships of arousal, sleep behaviors, lifetime sleep quality, life events and perimenopause status to sleep variables, and describe the relationships between a) life events and cognitive/emotional and somatic arousal indicators. Women (n=60), 40-55 years of age, experiencing sleep difficulties for at least 3 months that have begun or worsened within the last 3 years, who attribute some day-time effects to the insomnia, with no history of physical or mental disease or recent or prolonged shiftwork, drug abuse, or experiencing chronic pain will be recruited and screened for psychopathology using the SCL 90. A comparison group (n=30), of similar age reporting good sleep will also be recruited. Objective sleep will be monitored by standard polysomnography and subjective sleep on a sleep diary, cognitive/emotional arousal by the POMS and Spielberger Anxiety Inventory, somatic arousal during waking by responsivity to stressors in trapezius and frontalis EMG, skin temperature and skin conductance and during sleep by mean rectal temperature, facial EMG and urinary catecholamines and cortisol. Sleep behaviors and lifetime sleep will be measured on a sleep history and environmental stressors by the Norbeck Life Events survey.