Bonnet M H, Arand D L
Dayton Department of Veterans Affairs Medical Center, Wright State University, Kettering Medical Center, and Wallace Kettering Neuroscience Institute, Dayton, OH 45428, USA.
J Intern Med. 2003 Jul;254(1):23-31. doi: 10.1046/j.1365-2796.2003.01176.x.
Studies have shown occasional evidence of increased physiological activity in patients with primary insomnia. We hypothesized that metabolic rate, as measured by overall oxygen use (VO2), might be a more general index of increased physiological activity. An initial experiment found elevated VO2 both at night and during the day in patients with primary insomnia as compared with matched normal sleepers. A second experiment found significant but more modest increases in VO2 in patients with Sleep State Misperception Insomnia [who complain of poor sleep but who had normal sleep by electroencephalographic (EEG) criteria]. In a third experiment, normal young adults were given caffeine 400 mg three times per day (TID) for 1 week as a means of increasing VO2 and possibly producing other symptoms of insomnia. Participants developed many symptoms consistent with those seen in patients with primary insomnia (poor sleep, increased latency on the Multiple Sleep Latency Test, increasing fatigue despite physiological activation, and increased anxiety on the Minnesota Multiphasic Personality Inventory (MMPI)). In a final experiment, physiological arousal was again produced by caffeine to determine if sleep with elevated arousal would be less restorative. All subjects (Ss) slept for 3.5 h after being given 400 mg of caffeine. During 41 h of sleep deprivation that followed, there was no significant condition difference for the Multiple Sleep Latency Test or mood measures. The results provided only weak support for the idea that sleep is less restorative after physiological arousal.
研究显示，原发性失眠患者偶尔会出现生理活动增强的迹象。我们推测，以总耗氧量（VO2）衡量的代谢率，可能是生理活动增强的一个更普遍指标。最初的一项实验发现，与匹配的正常睡眠者相比，原发性失眠患者在夜间和白天的VO2均有所升高。第二项实验发现，睡眠状态认知错误性失眠患者（抱怨睡眠不佳，但根据脑电图（EEG）标准睡眠正常）的VO2有显著但较为适度的升高。在第三项实验中，正常的年轻成年人每天三次服用400毫克咖啡因，持续1周，以此提高VO2，并可能引发其他失眠症状。参与者出现了许多与原发性失眠患者所见症状一致的症状（睡眠不佳、多次睡眠潜伏期测试中的潜伏期延长、尽管有生理激活但疲劳加剧，以及明尼苏达多相人格调查表（MMPI）上的焦虑增加）。在最后一项实验中，再次通过咖啡因引发生理唤醒，以确定唤醒水平升高时的睡眠恢复效果是否会降低。所有受试者在服用400毫克咖啡因后睡了3.5小时。在随后41小时的睡眠剥夺期间，多次睡眠潜伏期测试或情绪测量方面没有显著的条件差异。这些结果仅为“生理唤醒后睡眠恢复效果降低”这一观点提供了微弱支持。
