Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA.
Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Department of Psychology, Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, USA.
Int J Psychophysiol. 2021 Jun;164:87-94. doi: 10.1016/j.ijpsycho.2021.02.019. Epub 2021 Feb 26.
Insomnia disorder is a common sleep disorder and frequently emerges in the context of menopause, being associated with menopause-specific factors such as hot flashes and other psychosocial variables. Increased vulnerability to stress may also contribute to the development of insomnia in midlife women. Here, we aimed to investigate whether there are differences in physiological reactivity to acute psychosocial stress in women with menopausal insomnia compared with controls.
We investigated cortisol and heart rate [HR] responses to an acute experimental psychosocial stress (Trier Social Stress Test, TSST) approximately 1 h after waking in the morning in midlife women with (n = 22) and without (n = 16) DSM-IV insomnia disorder (Age: 50.05 ± 3.10 years), developed in the context of menopause.
Despite similar perceived stress levels, women with insomnia showed blunted HR increases (29% HR acceleration) to the TSST compared to controls (44% HR acceleration) (p = 0.026). No group differences in HR were detected at baseline or during post-task recovery. Cortisol stress responses were inconclusive, with most of the women (60%) failing to exhibit significant cortisol increases in response to the TSST. A greater magnitude of the cortisol awakening response (CAR) predicted the likelihood of being a non-responder (p = 0.036), showing the confounding effect of CAR on cortisol stress responses.
Women with menopausal insomnia show blunted cardiac responses to stress, suggesting alterations in the autonomic reactivity to acute stress. Whether these alterations are pre-existing or are a consequence of insomnia, needs to be determined.
失眠障碍是一种常见的睡眠障碍，常出现在更年期背景下，与潮热等更年期特有因素以及其他心理社会变量有关。压力易感性增加也可能导致中年女性失眠的发生。在这里，我们旨在研究更年期失眠女性与对照组相比，在急性心理社会应激下的生理反应是否存在差异。
我们大约在早上醒来后 1 小时，通过急性实验性心理社会应激（Trier 社会应激测试，TSST），调查了中年女性（年龄：50.05 ± 3.10 岁）中，有无 DSM-IV 失眠障碍（n=22，n=16）的皮质醇和心率[HR]对急性心理社会应激的反应。失眠障碍是在更年期背景下发展起来的。
尽管感知压力水平相似，但与对照组相比（44% HR 加速），失眠组的 HR 增加幅度较小（29% HR 加速）（p=0.026）。在基线或任务后恢复期间，两组的 HR 均无差异。皮质醇应激反应不确定，大多数女性（60%）对 TSST 没有明显的皮质醇增加反应。皮质醇觉醒反应（CAR）的幅度越大，预示着成为非反应者的可能性越大（p=0.036），表明 CAR 对皮质醇应激反应的混杂作用。
更年期失眠女性对压力的心脏反应较弱，表明自主反应对急性压力的改变。这些改变是预先存在的，还是失眠的结果，需要进一步确定。
