Backhaus Jutta, Junghanns Klaus, Hohagen Fritz
Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany.
Psychoneuroendocrinology. 2004 Oct;29(9):1184-91. doi: 10.1016/j.psyneuen.2004.01.010.
Morning and evening salivary cortisol levels were correlated with sleep parameters in 14 patients with primary insomnia and 15 healthy controls. Salivary cortisol was sampled immediately after awakening (T1), 15 min later (T2), and immediately before going to bed (T3) for 1 week at home. In parallel with this, subjects estimated parameters of sleep in a daily sleep log. Patients and controls were all non-smokers who did not differ regarding morning awakening time or bedtime. Cortisol after awakening was significantly decreased in primary insomnia. Salivary cortisol at the time of awakening correlated negatively with the subjective estimation of sleep quality, i.e. a low salivary cortisol level directly after awakening correlated with a higher frequency of nightly awakenings (r = -0.50), a diminished sleep quality (r = -0.34) and a decreased feeling of recovery after awakening (r = -0.35; all p < 0.05). Furthermore, awakening cortisol was negatively correlated with the Pittsburgh Sleep Quality Index (r = -0.43) and with a questionnaire on sleep-related cognitions with the subscales rumination in bed (r = -0.56 ) and focusing on sleep-related thoughts (r = -0.46; all p < 0.05).
对14名原发性失眠患者和15名健康对照者的晨晚间唾液皮质醇水平与睡眠参数进行了相关性研究。在家中连续1周，在醒来后立即（T1）、15分钟后（T2）以及睡前立即（T3）采集唾液皮质醇样本。与此同时，受试者在每日睡眠日志中记录睡眠参数。患者和对照者均为非吸烟者，在早晨醒来时间和就寝时间方面无差异。原发性失眠患者醒来后的皮质醇水平显著降低。醒来时的唾液皮质醇水平与睡眠质量的主观评估呈负相关，即醒来后唾液皮质醇水平低与夜间觉醒频率较高（r = -0.50）、睡眠质量下降（r = -0.34）以及醒来后恢复感降低（r = -0.35；均p < 0.05）相关。此外，醒来时的皮质醇水平与匹兹堡睡眠质量指数呈负相关（r = -0.43），与一份关于睡眠相关认知的问卷呈负相关，该问卷的子量表包括床上反刍（r = -0.56）和关注睡眠相关想法（r = -0.46；均p < 0.05）。
