Stress Reactivity in Insomnia

失眠是最普遍的睡眠障碍，影响着美国6%-10%的人。 人口，并与一些日间后遗症有关。然而，几乎没有 已知潜在的神经生物学机制可能导致 失眠。有初步证据表明，压力系统可能在 在失眠病因学中的作用。本研究的目标是检查 失眠症患者是否比健康人对压力更敏感？ 卧铺。我们假设失眠症患者会表现出对 对压力源的预期。 拟议的项目将包括20名患有原发性失眠和 20名年龄和性别匹配的健康睡眠对照组。在收集了 在睡眠实验室的背景测量和适应之夜，受试者 将经历一个基线和压力之夜。在他们习惯性的30分钟之前 睡觉时间，在早上醒来的时候，在醒来后30分钟， 受试者将提供唾液样本和对他们目前水平的完整评级 压力。关于适应和基线之夜，不需要额外的程序 地点。在紧张的夜晚，轻微的电击将被施加到 课题首先在研究人员身上进行论证。到那时，他们将成为 他们被告知，他们可能会在夜间受到多达3次额外的电击， 尽管他们实际上不会受到任何更多的冲击。主要结果是 测量的是压力之夜睡眠潜伏期的反应性，与 基线之夜。次要结果测量是：压力的主观评级， 唾液皮质醇和α-淀粉酶，睡眠数量和质量，高频 脑电功率和心率变异性。这项研究的结果将开始确定压力系统是否 在失眠的神经生物学中起着重要作用。增加我们对这一问题的认识 失眠的病因学可以改善对这种情况的预防和治疗 减轻失眠带来的巨大公共卫生负担。

Insomnia is the most prevalent sleep disorder, affecting 6-10% of the U.S. population, and is associated with a number of daytime sequelae. However, little is known about the underlying neurobiological mechanisms that might lead to insomnia. There is preliminary evidence that the stress system may play a major role in the etiology of insomnia. The goal of the present study is to examine whether individuals with insomnia are more reactive to stress than healthy sleepers. We hypothesize that insomniacs will show heightened reactivity to the anticipation of a stressor. The proposed project will include 20 individuals with primary insomnia and 20 age- and gender-matched healthy sleeping controls. After collection of background measures and an adaptation night in the sleep laboratory, subjects will undergo a baseline and stress night. At 30 minutes before their habitual bedtime, upon awakening in the morning, and 30 minutes after waking up, subjects will provide a saliva sample and complete ratings of their current level of stress. On the adaptation and baseline nights no additional procedures will take place. On the stress night a mild electric shock will be administered to the subject after it is first demonstrated on the research personnel. They will then be told that they may receive up to 3 additional electric shocks during the night, although they will not actually receive any more shocks. The primary outcome measure is reactivity of sleep latency on the stress night compared to the baseline night. Secondary outcome measures are: subjective ratings of stress, salivary cortisol and alpha-amylase, sleep quantity and quality, high frequency EEG power, and heart rate variability. The results of this study will begin to determine whether the stress system plays a role in the neurobiology of insomnia. Increasing our understanding of the etiology of insomnia may improve prevention and treatment of the condition and reduce the large public health burden of insomnia.