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慢性失眠障碍患者的睡眠反应性、睡前觉醒状态与神经内分泌激素之间的关联

Association Between Sleep Reactivity, Pre-Sleep Arousal State, and Neuroendocrine Hormones in Patients with Chronic Insomnia Disorder.

作者信息

Yu Ke, Xia Lan, Chen Hui-Hui, Zou Tian-Tian, Zhang Yu, Zhang Ping, Yang Ye, Wei Ru-Meng, Su Zeng-Feng, Chen Gui-Hai

机构信息

Department of Neurology (Sleep Disorder), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), Anhui Province, 238000, People's Republic of China.

Department of General Practice, The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), Anhui Province, 238000, People's Republic of China.

出版信息

Nat Sci Sleep. 2024 Dec 5;16:1907-1919. doi: 10.2147/NSS.S491040. eCollection 2024.

DOI:10.2147/NSS.S491040
PMID:39655316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11627101/
Abstract

PURPOSE

The purpose of this study was to look into the relationship between pre-sleep arousal state, sleep reactivity, and serum levels of neuroendocrine hormones (cortisol, copeptin, and corticotropin-releasing hormone) in patients with chronic insomnia disorders (CID), and whether the effects of sleep reactivity and pre-sleep arousal on insomnia are related to the levels of these neuroendocrine hormones.

PATIENTS AND METHODS

This study included 61 CID patients and 27 healthy controls (HC) whose base data were matched to those of the CID patients. The Pittsburgh Sleep Quality Index(PSQI), Pre-Sleep Arousal Scale (PSAS), and the Ford Insomnia Response to Stress Test (FIRST) were used to evaluate the participants' sleep, stress, and neuropsychological function. We measured the participants' serum concentration levels of cortisol, copeptin, and corticotropin-releasing hormone (CRH), using quantitative sandwich enzyme-linked immunosorbent assays.

RESULTS

The CID group had significantly greater serum levels of copeptin, CRH, and cortisol, as well as higher FIRST and PSAS scores than the HC group. The partial correlation analysis revealed a substantial and positive association among cortisol, CRH, copeptin PSQI, PSAS, and FIRST after adjusting for sex, age, depression, and cognition. Principal component analysis showed that PSQI, FIRST, and PSAS, as well as cortisol, CRH, and copeptin, were all loaded on factor 1.

CONCLUSION

Patients with CID showed increased sleep reactivity and pre-sleep arousal, which correlated with serum levels of cortisol, copeptin, and CRH. Changes in neuroendocrine hormone levels may influence how pre-sleep arousal and sleep reactivity affect the development of insomnia.

摘要

目的

本研究旨在探讨慢性失眠障碍（CID）患者睡前觉醒状态、睡眠反应性与神经内分泌激素（皮质醇、 copeptin 和促肾上腺皮质激素释放激素）血清水平之间的关系，以及睡眠反应性和睡前觉醒对失眠的影响是否与这些神经内分泌激素的水平有关。

患者与方法

本研究纳入了61例CID患者和27名健康对照者（HC），后者的基础数据与CID患者相匹配。采用匹兹堡睡眠质量指数（PSQI）、睡前觉醒量表（PSAS）和福特失眠应激反应测试（FIRST）来评估参与者的睡眠、应激和神经心理功能。我们使用定量夹心酶联免疫吸附测定法测量了参与者血清中皮质醇、copeptin和促肾上腺皮质激素释放激素（CRH）的浓度水平。

结果

与HC组相比，CID组的copeptin、CRH和皮质醇血清水平显著更高，FIRST和PSAS评分也更高。偏相关分析显示，在调整性别、年龄、抑郁和认知因素后，皮质醇、CRH、copeptin、PSQI、PSAS和FIRST之间存在显著正相关。主成分分析表明，PSQI、FIRST和PSAS，以及皮质醇、CRH和copeptin均载荷于因子1上。

结论

CID患者表现出睡眠反应性增加和睡前觉醒，这与皮质醇、copeptin和CRH的血清水平相关。神经内分泌激素水平的变化可能会影响睡前觉醒和睡眠反应性对失眠发生发展的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4413/11627101/f58351e8518e/NSS-16-1907-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4413/11627101/f58351e8518e/NSS-16-1907-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4413/11627101/f58351e8518e/NSS-16-1907-g0001.jpg

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