NURSING STUDY OF PERIMENOPAUSAL INSOMNIA

据说，失眠或睡眠不佳影响了15%-30%的一般人 人口和主要是中年妇女，导致大量使用和 滥用催眠药。睡眠不足会损害白天的功能，可能是一种 一些精神疾病的早期症状，并对心血管疾病有贡献 疾病和过早死亡。客观睡眠模式的研究 失眠症患者的研究表明，有些人有明确的睡眠变化， 其他人只能在短时间内和不自然的情况下进行评估 环境(实验室)可能会导致对程度的错误假设 或表现出的失眠类型。过度的压力唤醒和学习 与良好睡眠不相容的行为被认为是主要的 导致失眠的因素。初步研究表明， 有客观睡眠障碍和无客观睡眠障碍的失眠症女性 评估之夜有较高的心理困扰和证据 睡眠质量好的女性的躯体应激性更强。精炼 对一般压力唤醒和对挑战的压力反应的评估 提出了与客观睡眠模式相关的情况。支持性 结果将指导治疗处方并揭示评估 基于压力反应的指标。这项建议的具体目的 目的是：1)验证有无客观睡眠的失眠亚型 在家中监测更长时间的骚扰，2)检测阴性 环境调节是导致失眠的一个因素，3)比较 失眠亚型对应激反应指标的影响，4)检查 压力反应指标、心理苦恼、 压力暴露和应对策略是导致失眠的因素 有客观的睡眠障碍，5)开始测试两种疗法 为失眠的两种亚型量身定做。 这项研究的目的是评估6岁以上的客观睡眠模式 在家中过夜，确定解除女性失眠的效果 在实验室睡一晚，并评估一般应激性唤醒 以及对实验室压力应用的反应作为确定的基础 子类型。两种环境疗法治疗失眠的初步试验 条件反射和压力自我管理，应用于基于 将会进行评估。

Insomnia or poor sleep is said to affect from 15-30% of the general population and predominantly midlife women, leading to substantial use and misuse of hypnotics. Inadequate sleep impairs daytime function, may be an early sign of some psychiatric disorders, and contributes to cardiovascular disease and premature mortality. Studies of the objective sleep patterns of insomniacs have shown that some people have definite sleep changes and others do not but assessment over short times and in an unnatural environment (the laboratory) may lead to false assumptions about the extent or type of insomnia exhibited. Excessive stress arousal and learned behaviors incompatible with good sleep are believed to be major contributing factors to insomnia. Preliminary studies have shown that insomniac women with and without objective sleep disturbances based on one night of assessment have higher psychological distress and evidence of somatic stress arousal than women who are good sleepers. Refined assessment of general stress arousal and stress reactivity to a challenge situation in relation to objective sleep patterns is proposed. Supportive results would guide therapeutic prescriptions and reveal assessment indicators based on stress responses. The specific aims of this proposal are to: 1) validate insomnia subtypes with and without objective sleep disturbances by monitoring over longer times at home, 2) test for negative environmental conditioning as a contributing factor to insomnia, 3) compare insomnia subtypes on stress response indicators, 4) examine the relationships among stress response indicators, psychological distress, stress exposure, and coping strategies as contributing factors to insomnia with objective sleep disturbances, and 5) begin testing 2 therapies tailored for 2 of the subtypes of insomnia. The purposes of this study are to assess objective sleep patterns over 6 nights at home, determine the effect of removing women with insomnia to the laboratory for one night of sleep, and assess for general stress arousal and reaction to laboratory stress application as a basis of determining subtypes. A preliminary test of 2 therapies for insomnia, environmental conditioning and stress self-management, as applied to subtypes based on assessment will be done.