Perlis Michael L, Zee Jarcy, Swinkels Cindy, Kloss Jacqueline, Morgan Kevin, David Beverly, Morales Knashawn
Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
J Sleep Res. 2014 Oct;23(5):499-507. doi: 10.1111/jsr.12150. Epub 2014 Apr 15.
Whether subjects with insomnia exhibit good sleep on some interval basis is unclear. Prior research suggests that patients with insomnia are highly variable with respect to night-to-night sleep continuity, that more than 40% of patients exhibit temporal patterning of good sleep, and that nearly 90% of patients exhibit better than average sleep following 1 to 3 nights of relatively poor sleep. The aim of the present study was to replicate and extend the above-noted findings utilizing: (i) a large sample studied over an extended time interval (ii) absolute standards for 'good' and 'poor' sleep; and (iii) a formal statistical methodology to assess temporal patterning and the association of time in bed with bout duration of poor or average sleep. Thirty-three subjects with insomnia and 33 good sleepers completed sleep diaries over the course of 110 days. It was found that subjects with insomnia (compared to good sleepers) had more poor nights (e.g. about 39 versus 7% of the assessed nights), a higher probability of a having a poor night on any given occasion (60% greater probability than good sleepers) and more consecutive nights of poor sleep between good sleep nights (median bout duration of approximately three versus one night). Lastly, it was found that (as would be predicted by both the Spielman model and the two-process model) time in bed moderated bout duration in the insomnia group. That is, longer times in bed were associated with longer bouts of poor sleep.
失眠患者在某些时间段内是否能有良好睡眠尚不清楚。先前的研究表明，失眠患者在夜间睡眠连续性方面差异很大，超过40%的患者表现出良好睡眠的时间模式，近90%的患者在经历1至3个睡眠较差的夜晚后，睡眠质量会优于平均水平。本研究的目的是通过以下方式复制并扩展上述发现：（i）在较长时间间隔内对大量样本进行研究；（ii）采用“良好”和“不佳”睡眠的绝对标准；以及（iii）使用正式的统计方法来评估时间模式以及卧床时间与不佳或平均睡眠时长之间的关联。33名失眠患者和33名睡眠良好者在110天内完成了睡眠日记。结果发现，失眠患者（与睡眠良好者相比）有更多睡眠不佳的夜晚（例如，在评估的夜晚中，分别约为39%和7%），在任何给定情况下出现睡眠不佳夜晚的可能性更高（比睡眠良好者高60%），并且在良好睡眠夜晚之间有更多连续的睡眠不佳夜晚（不佳睡眠的中位时长约为三个夜晚，而睡眠良好者为一个夜晚）。最后，研究发现（正如斯皮尔曼模型和双过程模型所预测的那样），卧床时间对失眠组的睡眠不佳时长有调节作用。也就是说，卧床时间越长，睡眠不佳的时长就越长。
