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障碍有关 变化，寿命缩短，发病率增加，组织改变 恢复原状和免疫功能。失眠被认为是一种 继发于多种类型的复杂异质现象 精神病理学或医学状况。原发失眠表现 有或没有睡眠障碍的客观证据，并一直 与高环境压力事件相关，高水平 认知/情绪唤醒和躯体唤醒，习得 与睡眠和睡眠倾向不相容的行为 睡眠/清醒模式不足。然而，这些集群中的 描述亚型的因素还没有被研究过，特别是 在中年女性身上。这样的分类将会有所帮助 预测适当的干预措施。 这项研究的具体目的是：1)确定 有客观睡眠模式的失眠症女性比例 改变，2)比较失眠症女性和报告良好的女性 睡眠取决于认知/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)描述觉醒、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)生活之间的关系 事件和认知/情绪和躯体唤醒指标。 女性(n=60)，年龄40-55岁，睡眠困难 至少3个月内开始或恶化 3年来，世界卫生组织将一些白天的影响归因于失眠， 无身体或精神疾病病史，近期或长期 倒班、滥用药物或经历慢性疼痛 使用SCL-90招募和筛选精神病理学。一个 对照组(n=30)，年龄相仿，报告睡眠良好 也会被招募。客观睡眠将通过标准监测 多导睡眠图和睡眠日记中的主观睡眠， 由POMS和斯皮尔伯格焦虑引起的认知/情绪唤醒 清单，觉醒时的躯体唤醒由对 斜方肌和额肌肌电、皮肤温度和皮肤的应激源 电导和睡眠时的平均直肠温度、面部肌电 尿儿茶酚胺和皮质醇。睡眠行为和 终生睡眠将根据睡眠历史和 诺贝克生活事件调查的环境压力源。

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.