Liu Bin, Zou Mingxuan, Liu Lin, Wu Zhongying, Jin Yinchuan, Feng Yuting, Jia Qiannan, Li Mengze, Ren Lei, Yang Qun
Department of Military Medical Psychology, Air Force Medical University, Xi'an, People's Republic of China.
Public Health School, Shaanxi University of Chinese Medicine, Xi'an, People's Republic of China.
Nat Sci Sleep. 2025 Jun 4;17:1143-1162. doi: 10.2147/NSS.S517178. eCollection 2025.
There is an intricate relationship between sleep disturbances and perceived stress in firefighters. Network analysis offers novel perspectives for examining the interactions between diseases. Hence, this study aimed to elucidate the relationship between sleep disturbances and perceived stress in firefighters through network analysis approaches.
A total of 786 Chinese firefighters were included in this study. Two methodologies, the regularized partial correlation network (RPCN) and the directed acyclic graph (DAG), were employed to perform network analysis.
Within the RPCN, P2 "Unable to control important things" and P7 "Unable to control irritations in life" were identified as central symptoms that simultaneously maintained sleep disturbances and perceived stress among firefighters. S7 "Daytime dysfunction" and P3 "Felt nervous and stressed" were classified as bridge symptoms, connecting sleep disturbances with perceived stress and perpetuating their comorbid nature. From a probabilistic priority perspective, the DAG demonstrated that the bidirectional spiral between sleep disturbances and perceived stress might be attributed to the fact that the upstream symptom S7 "Daytime dysfunction" influenced the perceived self-efficacy dimension of perceived stress, which in turn influenced other sleep disturbance symptoms.
Our findings not only provided innovative insights into further understanding the relationship between sleep disturbances and perceived stress among firefighters, but also identified potential targets for ameliorating these symptoms, such as the central, bridge, and upstream symptoms. Future intervention programs should prioritize these potential targets. Through the implementation of interventions like mindfulness-based stress reduction, cognitive behavioral therapy, and group psychotherapy, tailored to address these targeted symptoms, it is feasible to effectively mitigate both sleep disturbances and perceived stress in firefighters, and ultimately improve the mental health of this particular occupational group.
消防员的睡眠障碍与感知压力之间存在复杂的关系。网络分析为研究疾病之间的相互作用提供了新的视角。因此，本研究旨在通过网络分析方法阐明消防员睡眠障碍与感知压力之间的关系。
本研究共纳入786名中国消防员。采用两种方法，即正则化偏相关网络（RPCN）和有向无环图（DAG）进行网络分析。
在RPCN中，P2“无法控制重要事情”和P7“无法控制生活中的烦恼”被确定为核心症状，它们同时维持着消防员的睡眠障碍和感知压力。S7“日间功能障碍”和P3“感到紧张和有压力”被归类为桥梁症状，将睡眠障碍与感知压力联系起来，并使它们的共病性质持续存在。从概率优先级的角度来看，DAG表明睡眠障碍与感知压力之间的双向螺旋可能归因于上游症状S7“日间功能障碍”影响了感知压力的自我效能维度，进而影响了其他睡眠障碍症状。
我们的研究结果不仅为进一步理解消防员睡眠障碍与感知压力之间的关系提供了创新见解，还确定了改善这些症状的潜在靶点，如核心、桥梁和上游症状。未来的干预项目应优先考虑这些潜在靶点。通过实施如基于正念减压、认知行为疗法和团体心理治疗等干预措施，针对性地解决这些靶向症状，有效减轻消防员的睡眠障碍和感知压力并最终改善这一特定职业群体的心理健康是可行的。
