Longitudinal Study of Predisoposition and Life Events in Triggering Insomnia

大多数失眠模型都假设个体易患失眠。 有催生因素。越来越多的证据表明，暴露在压力重重的生活事件中 会导致失眠。然而，研究还没有确定一种倾向于 失眠，或研究压力暴露与这种易感性的相互作用。这个 本研究的目的是前瞻性地确定睡眠反应性的重要性。 (即，可靠地表现出睡眠中断的非失眠症患者 应激)导致自然暴露后的慢性失眠 压力很大的生活事件。我们已经开发并验证了一种睡眠反应性的测量方法 正常个体的多导睡眠图可预测睡眠障碍的反应 实验室应激源和2)失眠在13个月内的未来发展 随访期。据推测，正常睡眠的个体没有 病前睡眠反应性高的失眠症将面临更大的风险(即， 易患上)暴露于应激性生活事件后发展成慢性失眠 与睡眠反应性低的人相比。将收集预期数据 来自2200名没有失眠的人关于他们压力生活的经历 在两年的评估期内的事件和失眠发生率。这是假设的 这两个因素在预测失眠方面的作用将大于相加效应 发病率(即暴露X易感交互作用)。实验室的预测价值 测量的睡眠反应性在预测失眠发生率方面也将在一项 在4年的随访期内随机选择的个体子集。识别和 以下可能发生失眠的个体将允许对表型进行研究 失眠在疾病发展之前的特征，改善我们的 对其时间进程及其与发病率的关系的有限了解，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 针对预防而不是治疗。

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.