Ekstedt Mirjam, Akerstedt Torbjörn, Söderström Marie
Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden.
Psychosom Med. 2004 Nov-Dec;66(6):925-31. doi: 10.1097/01.psy.0000145821.25453.f7.
Previous work has demonstrated a link between restricted sleep and risk indicators for cardiovascular and metabolic disease, such as levels of cortisol, lipids, and glucose. The present study sought to identify relations between polysomnographic measures of disturbed sleep (frequency of arousals from sleep, total sleep time, and sleep efficiency) and a number of such indicators. A second purpose was to relate the number of arousals to mood, stress, work characteristics, and other possible predictors in daily life.
Twenty-four people (10 men, 14 women; mean age 30 years), high vs. low on burnout, were recruited from a Swedish IT company. Polysomnographically recorded sleep was measured at home before a workday. Blood pressure, heart rate, morning blood sample, and saliva samples of cortisol were measured the subsequent working day. They were also recorded for diary ratings of sleep and stress, and a questionnaire with ratings of sleep, stress, work conditions, and mood was completed.
A stepwise regression analysis using sleep parameters as predictors brought out number of arousals as the best predictor of morning cortisol (serum and saliva), heart rate, systolic and diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL)-, low-density lipoprotein (LDL)-cholesterol, and LDL/HDL-ratio. Work stress/unclear boundaries between work and leisure time was the best predictor of arousals among the stress variables.
Consistent with sleep restriction experiments, sleep fragmentation was associated with elevated levels of metabolic and cardiovascular risk indicators of stress-related disorders. Number of arousals also seems to be related to workload/stress.
先前的研究表明，睡眠受限与心血管和代谢疾病的风险指标之间存在联系，如皮质醇、血脂和血糖水平。本研究旨在确定睡眠障碍的多导睡眠图测量指标（睡眠中觉醒频率、总睡眠时间和睡眠效率）与一系列此类指标之间的关系。第二个目的是将觉醒次数与情绪、压力、工作特征以及日常生活中的其他可能预测因素联系起来。
从一家瑞典信息技术公司招募了24人（10名男性，14名女性；平均年龄30岁），倦怠程度有高有低。在工作日之前在家中通过多导睡眠图记录睡眠情况。在随后的工作日测量血压、心率、晨起血样和皮质醇唾液样本。还记录了睡眠和压力的日记评分，并完成了一份关于睡眠、压力、工作条件和情绪评分的问卷。
以睡眠参数作为预测指标的逐步回归分析表明，觉醒次数是晨起皮质醇（血清和唾液）、心率、收缩压和舒张压、总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）胆固醇以及LDL/HDL比值的最佳预测指标。在压力变量中，工作压力/工作与休闲时间界限不清是觉醒次数的最佳预测指标。
与睡眠限制实验一致，睡眠碎片化与应激相关疾病的代谢和心血管风险指标水平升高有关。觉醒次数似乎也与工作量/压力有关。
