儿童期睡眠时高频脑电图活动与青少年期新发失眠症状有关。
Childhood high-frequency EEG activity during sleep is associated with incident insomnia symptoms in adolescence.
机构信息
Sleep Research & Treatment Center, Department of Psychiatry, College of Medicine, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA.
Sleep Medicine Center, Shantou University Medical College, Shantou, China.
出版信息
J Child Psychol Psychiatry. 2019 Jul;60(7):742-751. doi: 10.1111/jcpp.12945. Epub 2018 Jul 10.
BACKGROUND
Insomnia has been associated in cross-sectional studies with increased beta (15-35 Hz) electroencephalogram (EEG) power during nonrapid eye movement (NREM) sleep, an index of cortical hyperarousal. However, it is unknown whether this cortical hyperarousal is present before individuals with insomnia develop the disorder. To fill this gap, we examined the association of childhood sleep high-frequency EEG activity with incident insomnia symptoms (i.e., absence of insomnia symptoms in childhood but presence in adolescence).
METHODS
We studied a case-control subsample of 45 children (6-11 years) from the Penn State Child Cohort, a population-based random sample of 421 children, who were followed up after 8 years as adolescents (13-20 years). We examined low-beta (15-25 Hz) and high-beta (25-35 Hz) relative power at central EEG derivations during NREM sleep and, in secondary analyses, during sleep onset latency, sleep onset, and REM sleep. Incident insomnia symptoms were defined as the absence of parent-reported difficulty falling and/or staying asleep during childhood and a self-report of these insomnia symptoms during adolescence.
RESULTS
Childhood high-beta power during NREM sleep was significantly increased in children who developed insomnia symptoms in adolescence (n = 25) as compared to normal sleeping controls (n = 20; p = .03). Multivariable-adjusted logistic regression models showed that increased childhood high-beta EEG power during NREM sleep was associated with a threefold increased odds (95% CI = 1.12-7.98) of incident insomnia symptoms in adolescence. No other significant relationships were observed for other sleep/wake states or EEG frequency bands.
CONCLUSIONS
Increased childhood high-frequency EEG power during NREM sleep is associated with incident insomnia symptoms in adolescence. This study indicates that cortical hyperarousal during sleep may be a premorbid neurophysiological sign of insomnia, which may mediate the increased risk of psychiatric disorders associated with insomnia.
背景
横断面研究表明，非快速眼动（NREM）睡眠期间β（15-35 Hz）脑电（EEG）功率增加与皮质过度兴奋有关，这是皮质过度兴奋的一个指标。然而，目前尚不清楚这种皮质过度兴奋是否存在于患有失眠症的个体之前。为了填补这一空白，我们研究了儿童睡眠高频 EEG 活动与失眠症状（即儿童期无失眠症状而青少年期有失眠症状）的关联。
方法
我们对宾夕法尼亚州儿童队列的一个病例对照子样本（45 名 6-11 岁儿童）进行了研究，该队列是一个基于人群的 421 名儿童的随机样本，在 8 年后作为青少年（13-20 岁）进行了随访。我们在 NREM 睡眠期间检查了中央 EEG 衍生的低频β（15-25 Hz）和高频β（25-35 Hz）相对功率，在次要分析中，还检查了睡眠潜伏期、睡眠开始和 REM 睡眠期间的低频β和高频β相对功率。失眠症状是指父母报告的儿童期入睡和/或保持睡眠困难，以及青少年期自我报告的这些失眠症状。
结果
与正常睡眠对照组（n=20）相比，在青少年期出现失眠症状的儿童（n=25）在 NREM 睡眠期间，儿童时期的高频β功率明显增加（p=0.03）。多变量调整后的逻辑回归模型显示，NREM 睡眠期间儿童高频 EEG 功率增加与青少年期发生失眠症状的几率增加三倍相关（95% CI=1.12-7.98）。对于其他睡眠/觉醒状态或 EEG 频带，没有观察到其他显著关系。
结论
NREM 睡眠期间儿童高频 EEG 功率增加与青少年期的失眠症状有关。这项研究表明，睡眠期间皮质过度兴奋可能是失眠的一种前临床神经生理标志，它可能介导与失眠相关的精神障碍的风险增加。
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