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使用失眠症状的定性和定量标准对睡眠生理学进行比较分析。

Comparative analysis of sleep physiology using qualitative and quantitative criteria for insomnia symptoms.

作者信息

Lee Ruda, Larson Olivia, Dhaliwal Sammy, Moon Kibum, Gerardy Bethany, de Chazal Philip, Cistulli Peter A, Chen Ning-Hung, Han Fang, Li Qing Yun, Maislin Greg, McArdle Nigel, Penzel Thomas, Schwab Richard J, Tufik Sergio, Magalang Ulysses J, Singh Bhajan, Gislason Thorarinn, Pack Allan I, Keenan Brendan T, Younes Magdy, Gehrman Philip

机构信息

Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States.

Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States.

出版信息

Sleep. 2025 Mar 11;48(3). doi: 10.1093/sleep/zsae301.

Abstract

Despite decades of research, defining insomnia remains challenging due to its complex and variable nature. Various diagnostic systems emphasize the chronic nature of insomnia and its impact on daily functioning, relying heavily on patient self-reporting due to limitations in objective measures such as polysomnography (PSG). Discrepancies between subjective experiences and objective PSG results highlight the need for more nuanced approaches, such as electroencephalogram (EEG) spectral analysis, which reveals distinct patterns of high-frequency activity in individuals with insomnia. This study explores EEG markers of insomnia by integrating subjective reports with objective physiological markers, specifically ORP (Odds-Ratio-Product) and spectral features, to address inconsistencies found in previous research and clinical settings. Qualitative and quantitative definitions of insomnia are contrasted to highlight differences in sleep architecture and EEG characteristics. The research aims to determine whether groups defined by weekly frequency and daily duration of symptoms have different distribution patterns and which physiological characteristics best distinguish insomnia patients from controls. Our findings suggest that ORP, as a dependent variable, captures the most significant differences in the independent variables across the model. Elevated beta power in insomnia patients indicates increased cortical arousal, supporting the perspective of insomnia as a hyperarousal disorder. Future research should focus on using ORP to enhance the understanding of sleep disturbances in insomnia. Comprehensive evaluation of insomnia requires integrating qualitative, quantitative, and neurophysiological data to fully understand its impact on sleep architecture and quality.

摘要

尽管经过了数十年的研究,但由于失眠的性质复杂多变,对其进行定义仍然具有挑战性。各种诊断系统都强调失眠的慢性本质及其对日常功能的影响,由于多导睡眠图(PSG)等客观测量方法存在局限性,因此严重依赖患者的自我报告。主观体验与客观PSG结果之间的差异凸显了需要采用更细致入微的方法,例如脑电图(EEG)频谱分析,它揭示了失眠个体高频活动的独特模式。本研究通过将主观报告与客观生理指标(特别是优势比乘积(ORP)和频谱特征)相结合,探索失眠的EEG标志物,以解决先前研究和临床环境中发现的不一致问题。对比失眠的定性和定量定义,以突出睡眠结构和EEG特征的差异。该研究旨在确定由症状的每周频率和每日持续时间定义的组是否具有不同的分布模式,以及哪些生理特征最能将失眠患者与对照组区分开来。我们的研究结果表明,作为因变量的ORP在整个模型中捕捉到了自变量中最显著的差异。失眠患者中升高的β波功率表明皮质觉醒增加,支持了将失眠视为一种高觉醒障碍的观点。未来的研究应专注于使用ORP来加深对失眠睡眠障碍的理解。对失眠的综合评估需要整合定性、定量和神经生理学数据,以全面了解其对睡眠结构和质量的影响。

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