Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China Department of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China.
Pain. 2012 Mar;153(3):666-673. doi: 10.1016/j.pain.2011.12.003. Epub 2012 Jan 23.
This study investigated the sex differences, and the shared genetic and environmental factors underlying the associations of sleep disturbances (insomnia and sleep quality) with pain and somatic symptoms in both adolescents and middle-aged adults. We recruited 259 adolescents (69 with current insomnia) and their parents (256 middle-aged adults, 78 with current insomnia). Insomnia severity and sleep quality were measured by the Insomnia Severity Inventory (ISI) and Pittsburgh Sleep Quality Index (PSQI), respectively. Pain and somatic symptoms were measured by the Somatic Symptom Inventory and Visual Analogue Scale for overall pain. Subjects with insomnia scored higher on all measures of pain and somatic symptoms than non-insomnia patients, in both adolescents and adults (P<.001). Both pain and somatic measures were associated with ISI and PSQI scores after controlling for age, sex, depressive and anxiety symptoms. There was an interaction effect between insomnia and female sex on pain and somatic symptoms (P<.05), especially in adults. Pain and somatic symptoms ran in family with moderate heritability (range h(2)=0.15-0.42). The phenotypic associations of ISI and PSQI with pain and somatic measures were both contributed by genetic (range p(G)=0.41-0.96) and environmental (range p(E)=0.27-0.40) factors with a major genetic contribution. In summary, insomnia and poor sleep quality are closely associated with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population. A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms.
本研究调查了睡眠障碍（失眠和睡眠质量）与疼痛和躯体症状在青少年和中年成年人中的性别差异，以及潜在的共同遗传和环境因素。我们招募了 259 名青少年（69 名患有当前失眠症）及其父母（256 名中年成年人，78 名患有当前失眠症）。失眠严重程度和睡眠质量分别用失眠严重程度指数（ISI）和匹兹堡睡眠质量指数（PSQI）来衡量。疼痛和躯体症状通过躯体症状量表和整体疼痛视觉模拟量表来衡量。与非失眠症患者相比，患有失眠症的患者在所有疼痛和躯体症状测量指标上的得分都更高，无论是在青少年还是成年人中（P<.001）。在控制年龄、性别、抑郁和焦虑症状后，疼痛和躯体测量指标与 ISI 和 PSQI 评分相关。在失眠和女性性别之间存在疼痛和躯体症状的交互效应（P<.05），尤其是在成年人中。疼痛和躯体症状具有中等遗传力（范围 h(2)=0.15-0.42）。ISI 和 PSQI 与疼痛和躯体测量指标的表型关联均由遗传（范围 p(G)=0.41-0.96）和环境（范围 p(E)=0.27-0.40）因素共同贡献，遗传因素占主要贡献。总之，失眠和睡眠质量差与疼痛和躯体症状密切相关。失眠似乎调节了疼痛和躯体症状的性别差异，尤其是在成年人群中。共同的遗传易感性可能是失眠和睡眠质量与疼痛和躯体症状相关的基础。
