Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Prevention Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Sleep. 2019 May 1;42(5). doi: 10.1093/sleep/zsz043.
To determine longitudinal effects of experiences related to the Fukushima nuclear disaster on March 11, 2011, on insomnia risk among workers of nuclear power plants on identified disaster-related potential risk factors for the subtypes of insomnia.
We included a total of 1403 workers who responded to a questionnaire on insomnia-related symptoms measured by the Athens Insomnia Scale from 2011 to 2014 and on disaster-related experiences in 2011. We examined the longitudinal relationships between disaster-related experiences and insomnia using mixed-effect logistic regression models. We also used path analysis to examine the potential effects of disaster-related experiences on the subtypes of insomnia (i.e. initial, sleep maintenance, and early morning awakening).
All disaster-related experiences were significantly associated with insomnia, except death of a family member or colleague. We found that most of these types of traumatic exposure were associated with the risk of insomnia in a time-independent way. However, the effect of experiencing life-threatening danger decreased with time. Based on the results of the path analysis, we found that life-threatening experiences, such as experiences of life-threatening danger or witnessing the explosion, may conjure up disturbing scenes that hamper sleep initiation. On the other hand, early morning awakening may be related to life uncertainty. We found that social discrimination/slurs was associated with all three types of insomnia and was also influenced by other experiences, such as life-threatening danger, property loss, and colleague death.
Our findings emphasize the importance of comprehensive psychosocial support for workers with disaster-related experiences.
确定 2011 年 3 月 11 日福岛核灾难相关经历对核电厂工人失眠风险的纵向影响，并确定与潜在灾难相关的潜在风险因素对失眠亚型的影响。
我们共纳入了 1403 名工人，他们在 2011 年至 2014 年期间对与失眠相关的症状（采用雅典失眠量表进行测量）进行了问卷调查，并在 2011 年对与灾难相关的经历进行了问卷调查。我们使用混合效应逻辑回归模型来检查灾难相关经历与失眠之间的纵向关系。我们还使用路径分析来检查灾难相关经历对失眠亚型（即初始、睡眠维持和清晨觉醒）的潜在影响。
除了家庭成员或同事死亡外，所有与灾难相关的经历都与失眠显著相关。我们发现，这些创伤暴露类型中的大多数与失眠的风险呈时间独立相关。然而，经历危及生命的危险的影响随时间而降低。根据路径分析的结果，我们发现危及生命的经历，如经历危及生命的危险或目睹爆炸，可能会唤起干扰睡眠的场景。另一方面，清晨觉醒可能与生活的不确定性有关。我们发现，社会歧视/诽谤与所有三种类型的失眠有关，也受到其他经历的影响，如危及生命的危险、财产损失和同事死亡。
我们的研究结果强调了为有灾难相关经历的工人提供全面的社会心理支持的重要性。
