生理性过度兴奋是否会增加失眠患者的错误率？
Does physiological hyperarousal enhance error rates among insomnia sufferers?
机构信息
Department of Medicine, National Jewish Health, Denver, CO 80206, USA.
出版信息
Sleep. 2013 Aug 1;36(8):1179-86. doi: 10.5665/sleep.2882.
OBJECTIVE
To examine the association between physiological hyperarousal and response accuracy on reaction time tasks among individuals with insomnia.
DESIGN AND SETTING
This study was conducted at affiliated Veterans Administration (VA) and academic medical centers using a matched-group, cross-sectional research design.
PARTICIPANTS
Eighty-nine individuals (48 women) with primary insomnia, PI (MAge = 49.8 ± 17.2 y) and 95 individuals (48 women) who were well-screened normal sleepers, NS (MAge = 46.9 ± 17.0 y).
METHODS AND MEASURES
Participants underwent 3 nights of polysomnography followed by daytime testing with a four-trial Multiple Sleep Latency Test (MSLT). Before each MSLT nap, they rated their sleepiness and completed computer-administered reaction time tasks. The mean number of correct and error responses made by each participant across testing trials served as dependent measures. The PI and NS groups were each subdivided into alert (e.g., MSLT mean onset latency > 8 min) and sleepy (e.g., MSLT mean onset latency ≤ 8 min) subgroups to allow for testing the main and interaction effects of participant type and level of alertness.
RESULTS
Alert participants had longer MSLT latencies than sleepy participants (12.7 versus 5.4 min), yet both alert and sleepy individuals with PI reported greater sleepiness than NS. Alert participants also showed lower sleep efficiencies (83.5% versus 86.2%, P = 0.03), suggesting 24-h physiological hyperarousal particularly in the PI group. Individuals with PI had fewer correct responses on performance testing than did NS, whereas a significant group × alertness interaction (P = 0.0013) showed greater error rates among alert individuals with PI (mean = 4.5 ± 3.6 errors per trial) than among alert NS (mean = 2.6 ± 1.9 errors per trial).
CONCLUSIONS
Physiological hyperarousal in insomnia may lead to more apparent daytime alertness yet dispose individuals with insomnia to higher error rates on tasks requiring their attention.
目的
研究失眠症患者在反应时任务中生理过度兴奋与反应准确性之间的关系。
设计和设置
这项研究在附属退伍军人事务部（VA）和学术医疗中心进行，采用匹配组、横断面研究设计。
参与者
89 名原发性失眠症患者（48 名女性），PI（平均年龄=49.8±17.2 岁）和 95 名经过充分筛选的正常睡眠者，NS（平均年龄=46.9±17.0 岁）。
方法和措施
参与者接受了 3 个晚上的多导睡眠图检查，随后进行了 4 次多导睡眠潜伏期测试（MSLT）的日间测试。在每次 MSLT 小睡之前，他们会评估自己的困倦程度并完成计算机管理的反应时任务。每个参与者在整个测试试验中的正确和错误反应的平均数量作为因变量。将 PI 和 NS 组各自细分为警觉（例如，MSLT 平均潜伏期>8 分钟）和困倦（例如，MSLT 平均潜伏期≤8 分钟）亚组，以检验参与者类型和警觉水平的主要和交互效应。
结果
警觉参与者的 MSLT 潜伏期长于困倦参与者（12.7 分钟对 5.4 分钟），但 PI 的警觉和困倦参与者都报告说比 NS 更困倦。警觉参与者的睡眠效率也较低（83.5%对 86.2%，P=0.03），表明 PI 组尤其存在 24 小时生理过度兴奋。PI 患者在表现测试中的正确反应少于 NS，而显著的组×警觉性交互作用（P=0.0013）表明 PI 警觉患者的错误率更高（平均每试验 4.5±3.6 个错误）比警觉 NS（平均每试验 2.6±1.9 个错误）。
结论
失眠症患者的生理过度兴奋可能导致更明显的日间警觉，但会导致需要注意力的任务中的错误率更高。
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