Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; RAND Corporation, Pittsburgh, PA, USA.
J Psychosom Res. 2014 Mar;76(3):242-8. doi: 10.1016/j.jpsychores.2013.11.010. Epub 2013 Nov 25.
The interpersonal environment is strongly linked to sleep. However, little is known about interpersonal distress and its association with sleep. We examined the associations among interpersonal distress, objective and subjective sleep in people with and without insomnia.
Participants in this cross-sectional observational study included men and women with insomnia (n = 28) and good sleeper controls (n = 38). Interpersonal distress was measured with the Inventory of Interpersonal Problems. Sleep parameters included insomnia severity, self-reported presleep arousal, and sleep quality; and polysomnographically-assessed sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), percent delta (stage 3 + 4 NREM), percent REM, and EEG beta power. Hierarchical linear regression was used to assess the relationship between distress from interpersonal problems and sleep and the extent to which relationships differed among insomnia patients and controls.
More interpersonal distress was associated with more self-reported arousal and higher percentage of REM. More interpersonal distress was associated with greater insomnia severity and more cognitive presleep arousal for individuals with insomnia, but not for controls. Contrary to expectations, interpersonal distress was associated with shorter sleep latency in the insomnia group. Results were attenuated, but still significant, after adjusting for depression symptoms.
Distress from interpersonal problems is associated with greater self-reported arousal and higher percent REM. Individuals with insomnia who report more distress from interpersonal problems have greater insomnia severity and cognitive presleep arousal, perhaps due to rumination. These findings extend our knowledge of the association between interpersonal stressors and sleep. Assessment and consideration of interpersonal distress could provide a novel target for insomnia treatment.
人际环境与睡眠密切相关。然而，人际困扰及其与睡眠的关系知之甚少。我们研究了失眠症患者和非失眠症对照者的人际困扰与客观和主观睡眠之间的关系。
本横断面观察性研究的参与者包括失眠症患者（n=28）和睡眠良好的对照者（n=38）。采用人际问题清单评估人际困扰。睡眠参数包括失眠严重程度、入睡前觉醒自评和睡眠质量；以及多导睡眠图评估的睡眠潜伏期（SL）、总睡眠时间（TST）、睡眠后觉醒时间（WASO）、δ期（NREM 阶段 3+4）百分比、REM 百分比和 EEGβ功率。采用分层线性回归评估人际问题困扰与睡眠之间的关系，以及这些关系在失眠症患者和对照组中的差异程度。
更多的人际困扰与更多的自我报告觉醒和更高的 REM 百分比有关。对于失眠症患者，更多的人际困扰与更严重的失眠症和更多的认知性入睡前觉醒有关，但对于对照组则不然。与预期相反，人际困扰与失眠症患者的睡眠潜伏期缩短有关。调整抑郁症状后，结果仍然显著。
人际问题困扰与更大的自我报告觉醒和更高的 REM 百分比有关。报告更多人际困扰的失眠症患者的失眠症严重程度和认知性入睡前觉醒更大，可能是因为他们会反复思考。这些发现扩展了我们对人际压力源与睡眠之间关系的认识。评估和考虑人际困扰可能为失眠症治疗提供一个新的目标。
