Longitudinal Study of Predisoposition and Life Events in Triggering Insomnia

引发失眠的倾向和生活事件的纵向研究

• 批准号: 8024504
• 负责人: CHRISTOPHER L DRAKE
• 金额: $ 32.63万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-08 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8024504
• 关键词: Acute; Address; Adult; Affect; Area; Caffeine; Characteristics; Chronic Disease; Chronic Insomnia; Clinical Investigator; Comorbid Insomnia; Congestive; Consensus; Data; Development; Disease; Disease remission; Environmental Exposure; Event; Exhibits; Exposure to; Frequencies; Future; Goals; Health; Heart; Incidence; Individual; Laboratories; Life; Longitudinal Studies; Measures; Modeling; Morbidity - disease rate; Polysomnography; Populations at Risk; Precipitating Factors; Predictive Value; Predisposition; Prevention; Prospective Studies; Quality of life; Recording of previous events; Research; Risk; Risk Factors; Science; Severities; Sleep; Sleep Disorders; Sleep disturbances; Sleeplessness; Stress; Testing; United States National Institutes of Health; experience; follow-up; improved; prospective; response; stressor; symposium; trait

DESCRIPTION (provided by applicant): Most models of insomnia hypothesize an individual predisposition to the disorder along with precipitating factors. Converging evidence suggests exposure to stressful life events can precipitate insomnia. However, research has yet to identify a trait predisposition to insomnia, or investigated the interaction of stress exposure with that predisposition. The purpose of this study is to prospectively determine the importance of sleep reactivity (i.e., non-insomniac individuals who reliably exhibit sleep disruption in response to stress) for the development of chronic insomnia following naturalistic exposure to stressful life events. We have developed and validated a measure of sleep reactivity that in normal individuals is predictive of 1) polysomnographic sleep disturbance in response to laboratory stressors and 2) the prospective development of insomnia over a 13-month follow-up period. It is hypothesized that normal sleeping individuals without a history of insomnia who have a high premorbid sleep reactivity will be at greater risk (i.e., predisposed) to developing chronic insomnia following exposure to stressful life events when compared to individuals with low sleep reactivity. Prospective data will be collected from 2,200 individuals without insomnia regarding their experiences of stressful life events and insomnia incidence during a 2-year assessment period. It is hypothesized that these two factors will have a greater than additive effect in predicting insomnia incidence (i.e., exposure X predisposition interaction). The predictive value of laboratory measured sleep reactivity in predicting insomnia incidence will also be determined in a randomly selected subset of individuals over a 4 year follow up period. Identifying and following individuals who are likely to develop insomnia will allow the study of phenotypic traits characteristic of insomnia prior to the development of the disorder, improve our limited understanding of its temporal course and its association with morbidity, help identify specific triggers and their impact in at-risk populations, and permit efforts to be directed toward prevention rather than treatment. PUBLIC HEALTH RELEVANCE: Insomnia is a sleep disorder hypothesized to be triggered by stress in vulnerable individuals. The current proposal is a 2 year prospective study testing the hypothesis that elevated "sleep reactivity" is a predisposing risk factor for the development of chronic insomnia following exposure to stressful life events. Specifically, we hypothesize an interaction between stress and the predisposition to insomnia whereby individuals with a predisposition will have a higher incidence of the disorder given stress exposure compared to non-predisposed individuals.

描述（由申请人提供）：大多数失眠模型假设对该疾病的易感性以及降水因素。融合的证据表明，暴露于压力的生活事件会导致失眠。但是，研究尚未确定失眠症的性状倾向，或者研究了压力暴露与该易感性的相互作用。这项研究的目的是前瞻性确定睡眠反应性的重要性（即，在自然主义暴露于压力性生活事件之后，可靠地表现出响应压力的非无遗物个体对压力响应压力的睡眠中断）。我们已经制定并验证了睡眠反应性的量度，即在正常人中可以预测1）响应实验室压力源的多摄影术睡眠障碍，以及2）在13个月的随访期内失眠的前瞻性发展。假设与睡眠不足的人相比，患有慢性失眠的人（即倾向于易感性），没有失眠病史的正常睡眠患者没有失眠的病史，患有较高的睡眠前反应性（即，倾向于倾向）会面临慢性失眠的风险。预期数据将从2200名失眠的人中收集有关他们在2年评估期间的压力性生活事件和失眠率的经历。假设这两个因素在预测失眠率（即暴露x易经​​相互作用）方面将具有大于加性效应。实验室测量的睡眠反应性在预测失眠率中的预测价值也将在4年的随访期间随机选择的个体子集中确定。识别和跟随可能发展失眠症的人将允许研究疾病发展之前的失眠症​​特征的表型特征，提高我们对其时间病程的有限理解及其与发病率的关联，有助于识别特定的触发器及其对处于危险的人群的影响，并允许对预防而不是治疗，并允许努力努力。公共卫生相关性：失眠是一种睡眠障碍，该睡眠障碍是由脆弱者的压力引起的。当前的建议是一项为期2年的前瞻性研究，检验了一个假设，即升高的“睡眠反应性”是暴露于压力大的生活事件后慢性失眠的诱发风险因素。具体而言，我们假设压力与失眠的易感性之间存在相互作用，而与未临床的个体相比，在压力暴露的情况下，患有易感性的个体将有更高的疾病发生率。