Edinger Jack D, Means Melanie K, Carney Colleen E, Krystal Andrew D
VA Medical Center, Durham, NC 27705, USA.
Sleep. 2008 May;31(5):599-607. doi: 10.1093/sleep/31.5.599.
To examine psychomotor (reaction time) performance deficits and their relation to subjective and objective sleep measures among individuals with primary insomnia (PI).
This study was conducted at affiliated VA and academic medical centers using a matched-groups, cross-sectional research design.
Seventy-nine (43 women) individuals with PI (MAge = 50.0 +/- 17.1 y) and 84 (41 women) well-screened normal sleepers (MAge = 48.6 +/- 16.8 y).
Participants underwent 3 nights of polysomnography (PSG) followed by daytime testing with a 4-trial multiple sleep latency test (MSLT). Before each MSLT nap, they rated their sleepiness and completed a performance battery that included simple reaction time (SRT), continuous performance (CPT), and 4 switching attention (SAT) tests. Performance measures included the mean response latency and the standard deviation of each subject's within-test response latencies.
PI sufferers reported greater (P = 0.001) daytime sleepiness, but were significantly (P = 0.02), more alert than normal sleepers on the MSLT. Multivariate analyses showed the PI group had significantly longer response latencies and greater response variability across many of the subtests than did the controls. Regression analyses showed that both PSG- and diary-based sleep measures contributed to the prediction of daytime performance indices, although objective wake time after sleep onset appeared the best single predictor of the daytime measures.
Results confirm that PI sufferers do show relative psychomotor performance deficits when responding to challenging reaction time tasks, and these deficits appear related to both objective and subjective sleep deficits. Findings support PI patients' diurnal complaints and suggest the usefulness of complex reaction time tasks for assessing them.
研究原发性失眠（PI）患者的精神运动（反应时间）表现缺陷及其与主观和客观睡眠指标的关系。
本研究在退伍军人事务部附属和学术医疗中心进行，采用匹配组横断面研究设计。
79名（43名女性）PI患者（平均年龄 = 50.0 ± 17.1岁）和84名（41名女性）经过充分筛查的正常睡眠者（平均年龄 = 48.6 ± 16.8岁）。
参与者接受3晚的多导睡眠图（PSG）监测，随后进行日间测试，包括4次试验的多次睡眠潜伏期测试（MSLT）。在每次MSLT小睡之前，他们对自己的困倦程度进行评分，并完成一组表现测试，包括简单反应时间（SRT）、连续操作测试（CPT）和4项注意力转换（SAT）测试。表现指标包括每个受试者测试内反应潜伏期的平均反应潜伏期和标准差。
PI患者报告白天困倦程度更高（P = 0.001），但在MSLT上比正常睡眠者明显更警觉（P = 0.02）。多变量分析显示，PI组在许多子测试中的反应潜伏期明显更长，反应变异性更大。回归分析表明，基于PSG和日记的睡眠指标都有助于预测白天的表现指标，尽管睡眠开始后的客观清醒时间似乎是白天指标的最佳单一预测因素。
结果证实，PI患者在应对具有挑战性的反应时间任务时确实表现出相对的精神运动表现缺陷，这些缺陷似乎与客观和主观睡眠缺陷都有关。研究结果支持PI患者的日间主诉，并表明复杂反应时间任务对评估他们的有用性。
