失眠障碍的聚类分析：客观睡眠参数的探索性聚类分析揭示神经认知功能、定量脑电图和心率变异性的差异。
Clusters of Insomnia Disorder: An Exploratory Cluster Analysis of Objective Sleep Parameters Reveals Differences in Neurocognitive Functioning, Quantitative EEG, and Heart Rate Variability.
作者信息
Miller Christopher B, Bartlett Delwyn J, Mullins Anna E, Dodds Kirsty L, Gordon Christopher J, Kyle Simon D, Kim Jong Won, D'Rozario Angela L, Lee Rico S C, Comas Maria, Marshall Nathaniel S, Yee Brendon J, Espie Colin A, Grunstein Ronald R
机构信息
CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Australia.
Sydney Medical School, University of Sydney, Australia.
出版信息
Sleep. 2016 Nov 1;39(11):1993-2004. doi: 10.5665/sleep.6230.
STUDY OBJECTIVES
To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative ()-EEG and heart rate variability (HRV).
METHODS
Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters.
RESULTS
From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P < 0.05). Preliminary work suggested three clusters by retaining the I-NSD and splitting the I-SSD cluster into two: I-SSD A (n = 29): defined by high WASO and I-SSD B (n = 14): a second I-SSD cluster with high SOL and medium WASO. The I-SSD B cluster performed worse than I-SSD A and I-NSD for sustained attention (P ≤ 0.05). In an exploratory analysis, -EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05).
CONCLUSIONS
Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset -EEG.
CLINICAL TRIAL REGISTRATION
Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.
研究目的
通过多导睡眠图（PSG）聚类分析，实证推导并评估失眠障碍的潜在聚类。我们假设不同聚类在神经认知表现、睡眠起始的定量脑电图（qEEG）及心率变异性（HRV）测量指标上存在差异。
方法
患有失眠障碍（符合《精神疾病诊断与统计手册》第5版[DSM-5]）的研究志愿者完成了一项神经认知评估，并采用整夜PSG测量的总睡眠时间（TST）、睡眠起始后觉醒时间（WASO）和睡眠起始潜伏期（SOL）来确定聚类。
结果
在96名患有失眠障碍的志愿者中，聚类分析从客观睡眠参数中得出至少两个聚类：客观睡眠时长正常的失眠（I-NSD：n = 53）和睡眠时长较短的失眠（I-SSD：n = 43）。在睡眠起始时，I-NSD和I-SSD聚类之间HRV的差异表明I-SSD中副交感神经活动减弱（P < 0.05）。初步研究通过保留I-NSD并将I-SSD聚类分为两个聚类，得出三个聚类：I-SSD A（n = 29）：由高WASO定义；I-SSD B（n = 14）：第二个I-SSD聚类，具有高SOL和中等WASO。在持续注意力方面，I-SSD B聚类的表现比I-SSD A和I-NSD差（P≤0.05）。在一项探索性分析中，与I-SSD A和I-NSD相比，qEEG显示I-SSD B在睡眠起始前（δ、α、β-1）和睡眠起始后（β-2）的频谱功率也降低（P≤0.05）。
结论
通过聚类分析得出的两个失眠聚类在睡眠起始HRV上存在差异。初步数据表明，失眠存在三个聚类的证据，在持续注意力和睡眠起始qEEG方面存在差异。
临床试验注册
失眠100睡眠研究：澳大利亚新西兰临床试验注册中心（ANZCTR）识别号12612000049875。网址：https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742。
Zotero 插件