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青少年的睡眠反应性及相关因素:失眠风险增加?一项纵向评估。

Sleep Reactivity and Related Factors in Adolescence: An Increased Risk for Insomnia? A Longitudinal Assessment.

作者信息

Kater Maren-Jo, Werner Anika, Schlarb Angelika Anita, Lohaus Arnold

机构信息

Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany.

Faculty of Psychology and Sports Science Clinical, Department of Psychology and Psychotherapy of Children and Adolescents, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany.

出版信息

Nat Sci Sleep. 2023 Apr 11;15:207-216. doi: 10.2147/NSS.S401452. eCollection 2023.

Abstract

PURPOSE

The individual vulnerability for stress-related sleep difficulties (eg, sleep reactivity) is known as a predisposing factor of insomnia in adults, yet relatively little is known about sleep reactivity in adolescence. The study goal is to determine factors related to sleep reactivity and to investigate whether sleep reactivity and related factors predict current and new incidents of insomnia in adolescents.

PATIENTS AND METHODS

At baseline, 11-to-17-year-olds (N = 185, M = 14.3 years, SD = 1.8, 54% female) answered an age-appropriate version of the Ford Insomnia Response to Stress Test, questionnaires about sleep, stress, psychological symptoms, and resources, filled out a sleep diary and used actigraphy. Insomnia diagnoses according to ISCD-3 criteria were assessed at baseline, after 9 months and after one and a half years.

RESULTS

Adolescents with high compared to low sleep reactivity had increased pre-sleep arousal, negative sleep-related cognitions, pre-sleep mobile phone use, stress experience, stress vulnerability, internalizing and externalizing symptoms, less social resources, and a later midpoint of bedtime. High sleep reactivity increased the likelihood for currently having insomnia, but not for the development of insomnia at subsequent assessments.

CONCLUSION

The findings suggest that high sleep reactivity is related to poor sleep health and mental health but cast doubt on sleep reactivity as a pivotal predisposing factor for the development of insomnia in adolescence.

摘要

目的

个体对应激相关睡眠困难(如睡眠反应性)的易感性是成年人失眠的一个诱发因素,但对于青少年的睡眠反应性了解相对较少。本研究的目标是确定与睡眠反应性相关的因素,并调查睡眠反应性及相关因素是否能预测青少年当前及新发的失眠情况。

患者与方法

在基线时,11至17岁的青少年(N = 185,平均年龄M = 14.3岁,标准差SD = 1.8,女性占54%)回答了适合其年龄版本的福特失眠应激反应测试问卷、关于睡眠、压力、心理症状及资源的问卷,填写了睡眠日记并使用了活动记录仪。根据国际睡眠障碍分类第三版(ISCD - 3)标准在基线、9个月后及一年半后评估失眠诊断情况。

结果

与低睡眠反应性的青少年相比,高睡眠反应性的青少年睡前觉醒增加、与睡眠相关的消极认知、睡前使用手机、压力体验、压力易感性、内化和外化症状、社交资源较少,且就寝时间中点较晚。高睡眠反应性增加了当前患失眠症的可能性,但对后续评估中失眠症的发生发展并无影响。

结论

研究结果表明,高睡眠反应性与睡眠健康和心理健康不佳有关,但对睡眠反应性作为青少年失眠症发展的关键诱发因素这一观点提出了质疑。

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Is a blunted cortisol response to stress a premorbid risk for insomnia?应激时皮质醇反应迟钝是否是失眠的一种前驱性风险?
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