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: 8240525
• 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/8240525
• 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; 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

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.

大多数失眠模型都假设个体对这种疾病的易感性 有诱发因素。越来越多的证据表明，接触过压力性生活事件 会导致失眠。然而，研究尚未确定一种特质倾向 失眠，或研究压力暴露与这种倾向的相互作用。这 本研究的目的是前瞻性地确定睡眠反应性的重要性 （即，非失眠症患者确实表现出睡眠中断的反应 压力）对于自然暴露后慢性失眠的发展 有压力的生活事件。我们开发并验证了一种睡眠反应性测量方法 正常个体可预测 1) 多导睡眠图睡眠障碍的反应 实验室压力源以及 2) 13 个月内失眠的预期发展 随访期。据推测，没有睡眠史的正常睡眠者 病前睡眠反应性较高的失眠患者面临更大的风险（即， 暴露于生活压力事件后易患慢性失眠 与睡眠反应性低的人相比。将收集前瞻性数据 来自 2,200 名没有失眠症的人关于他们压力生活的经历 两年评估期内的事件和失眠发生率。据推测 这两个因素对预测失眠的影响大于相加效应 发生率（即暴露 X 易感性相互作用）。实验室预测价值 预测失眠发生率的测量睡眠反应性也将在 在 4 年的随访期内随机选择的个体子集。识别和 跟踪可能出现失眠的个体将允许研究表型 在疾病发展之前失眠的特征，改善我们的 对它的时间过程及其与发病率的关系了解有限，帮助 确定具体的触发因素及其对高危人群的影响，并允许努力 旨在预防而不是治疗。