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慢性可卡因使用者的睡眠、睡眠依赖性程序性学习与警觉性:隐匿性失眠的证据。

Sleep, sleep-dependent procedural learning and vigilance in chronic cocaine users: Evidence for occult insomnia.

作者信息

Morgan Peter T, Pace-Schott Edward F, Sahul Zakir H, Coric Vladimir, Stickgold Robert, Malison Robert T

机构信息

Department of Psychiatry, Yale University School of Medicine and Connecticut Mental Health Center, Clinical Neuroscience Research Unit, 34 Park Street, New Haven, CT 06519, USA.

出版信息

Drug Alcohol Depend. 2006 May 20;82(3):238-49. doi: 10.1016/j.drugalcdep.2005.09.014. Epub 2005 Nov 2.


DOI:10.1016/j.drugalcdep.2005.09.014
PMID:16260094
Abstract

Sleep disturbance has been implicated in cocaine use; however, the nature of the disturbance and its potential effects on cognition and learning are largely unknown. Twelve chronic cocaine users completed a 23-day inpatient study that included randomized, placebo-controlled, cocaine self-administration sessions. Six subjects received cocaine on each of days 4-6 and placebo on days 18-20, the other six received cocaine on each of days 18-20 and placebo on days 4-6. Sleep was measured by polysomnography, the Nightcap sleep monitor, and self-reported measures. Simple and vigilance reaction times were measured daily; a motor-sequence test of procedural learning was administered four times. Electrophysiological measures of sleep showed a different pattern than self-reported sleep across cocaine administration and abstinence: total sleep time and sleep latency were at their worst by 14-17 days of abstinence while self-reported sleep was at its best. Vigilance correlated positively with electrophysiologically measured sleep and negatively with self-reported measures. Similarly, sleep-dependent procedural learning correlated with total sleep time and was impaired at 17 days abstinence relative to 2- and 3-days abstinence. Slow-wave activity was lowest at days 4-9 of abstinence and highest during use and days 10-17 of abstinence. With sustained abstinence, chronic cocaine users exhibit decreased sleep, impaired vigilance and sleep-dependent procedural learning, and spectral activity suggestive of chronic insomnia. However, they report subjectively improving sleep, indicating they are unaware of this "occult" insomnia. These results suggest the possibility of homeostatic sleep drive dysregulation in chronic cocaine users.

摘要

睡眠障碍与可卡因使用有关;然而,这种障碍的性质及其对认知和学习的潜在影响在很大程度上尚不清楚。12名慢性可卡因使用者完成了一项为期23天的住院研究,该研究包括随机、安慰剂对照的可卡因自我给药环节。6名受试者在第4 - 6天每天服用可卡因,在第18 - 20天服用安慰剂,另外6名受试者在第18 - 20天每天服用可卡因,在第4 - 6天服用安慰剂。通过多导睡眠图、Nightcap睡眠监测仪和自我报告测量来监测睡眠。每天测量简单反应时间和警觉反应时间;对程序性学习进行了4次运动序列测试。睡眠的电生理测量结果显示,在可卡因给药和戒断期间,与自我报告的睡眠情况呈现出不同的模式:戒断14 - 17天时总睡眠时间和睡眠潜伏期最差,而自我报告的睡眠情况最佳。警觉性与电生理测量的睡眠呈正相关,与自我报告的测量结果呈负相关。同样,依赖睡眠的程序性学习与总睡眠时间相关,与2 - 3天戒断相比,在戒断17天时受到损害。慢波活动在戒断第4 - 9天最低,在使用期间和戒断第10 - 17天最高。随着持续戒断,慢性可卡因使用者表现出睡眠减少、警觉性受损和依赖睡眠的程序性学习受损,以及提示慢性失眠的频谱活动。然而,他们主观上报告睡眠有所改善,表明他们并未意识到这种“隐匿性”失眠。这些结果提示慢性可卡因使用者存在内稳态睡眠驱动力失调的可能性。

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Sleep, sleep-dependent procedural learning and vigilance in chronic cocaine users: Evidence for occult insomnia.

Drug Alcohol Depend. 2006-5-20

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