Nutley Sara K, Read Michael, Eichenbaum Joseph, Nosheny Rachel L, Weiner Michael W, Mackin R Scott, Mathews Carol A
Department of Epidemiology, University of Florida, Gainesville, Florida.
Department of Psychiatry, University of Florida, Gainesville, Florida.
Biol Psychiatry Glob Open Sci. 2021 Nov 5;2(4):480-488. doi: 10.1016/j.bpsgos.2021.10.009. eCollection 2022 Oct.
Hoarding disorder is a chronic psychiatric condition of increasing public health concern. Recent investigation suggests a positive association between hoarding severity and insomnia symptoms. However, these findings have yet to be replicated, and the prevalence and type of sleep impairment experienced by individuals with clinically relevant hoarding symptoms (CHSs) are not known.
This analysis of 20,473 members of the internet-based Brain Health Registry uses multivariate logistic regression modeling and structural equation modeling to evaluate the relationship between hoarding symptoms, sleep impairment, adverse health, and cognitive functioning.
More than 12% of study participants endorsed CHSs or subclinical hoarding symptoms. After adjustment for demographic characteristics and psychiatric comorbidity, individuals with CHSs reported increased odds of sleep impairment in nearly all domains. The odds of poor sleep quality (adjusted odds ratio, 2.07; 95% CI, 1.83-2.34), sleep disturbances (adjusted odds ratio, 2.15; 95% CI, 1.91-2.43), and daytime dysfunction (adjusted odds ratio, 5.84; 95% CI, 5.12-6.65) were two- to fivefold higher for individuals with CHSs compared with those without. For all measures, the proportion of individuals reporting sleep impairment increased with hoarding severity. In our structural equation model, sleep impairment acted as a partial mediator on the indirect pathways from hoarding to subjective cognitive complaints and poorer quality of life.
Identification of sleep problems among those with hoarding symptoms is a critical component of hoarding assessment. Additional research is needed to better understand the mechanisms underlying the observed relationships, including neurobiological underpinnings, and to examine the role of sleep management in treatment for hoarding behaviors.
囤积障碍是一种日益引起公众健康关注的慢性精神疾病。近期调查表明囤积严重程度与失眠症状之间存在正相关。然而，这些发现尚未得到重复验证，且具有临床相关囤积症状（CHSs）的个体所经历的睡眠障碍的患病率和类型尚不清楚。
对基于互联网的大脑健康登记处的20473名成员进行的这项分析，使用多变量逻辑回归模型和结构方程模型来评估囤积症状、睡眠障碍、不良健康状况和认知功能之间的关系。
超过12%的研究参与者认可CHSs或亚临床囤积症状。在调整人口统计学特征和精神共病后，患有CHSs的个体在几乎所有领域报告睡眠障碍的几率都有所增加。与没有CHSs的个体相比，患有CHSs的个体睡眠质量差（调整后的优势比，2.07；95%可信区间，1.83 - 2.34）、睡眠干扰（调整后的优势比，2.15；95%可信区间，1.91 - 2.43）和日间功能障碍（调整后的优势比，5.84；95%可信区间，5.12 - 6.65）的几率高出两到五倍。对于所有指标，报告睡眠障碍的个体比例随着囤积严重程度的增加而增加。在我们的结构方程模型中，睡眠障碍在从囤积到主观认知抱怨和较差生活质量的间接途径中起部分中介作用。
识别有囤积症状者的睡眠问题是囤积评估的关键组成部分。需要进一步研究以更好地理解所观察到的关系背后的机制，包括神经生物学基础，并研究睡眠管理在囤积行为治疗中的作用。
