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Ten-Year Stability of an Insomnia Sleeper Phenotype and Its Association With Chronic Conditions. 失眠者睡眠表型的 10 年稳定性及其与慢性疾病的关系。
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-02-16 DOI: 10.1097/PSY.0000000000001288
Soomi Lee, Claire E Smith, Meredith L Wallace, Orfeu M Buxton, David M Almeida, Sanjay R Patel, Ross Andel

Objective: To identify distinct sleep health phenotypes in adults, examine transitions in sleep health phenotypes over time, and subsequently relate these to the risk of chronic conditions.

Methods: A national sample of adults from the Midlife in the United States study ( N = 3683) provided longitudinal data with two time points (T1: 2004-2006, T2: 2013-2017). Participants self-reported on sleep health (regularity, satisfaction, alertness, efficiency, duration) and the number and type of chronic conditions. Covariates included age, sex, race, education, education, partnered status, number of children, work status, smoking, alcohol, and physical activity.

Results: Latent transition analysis identified four sleep health phenotypes across both time points: good sleepers, insomnia sleepers, weekend catch-up sleepers, and nappers. Between T1 and T2, the majority (77%) maintained their phenotype, with the nappers and insomnia sleepers being the most stable. In fully adjusted models with good sleepers at both time points as the reference, being an insomnia sleeper at either time point was related to having an increased number of total chronic conditions by 28%-81% at T2, adjusting for T1 conditions. Insomnia sleepers at both time points were at 72%-188% higher risk for cardiovascular disease, diabetes, depression, and frailty. Being a napper at any time point related to increased risks for diabetes, cancer, and frailty. Being a weekend catch-up sleeper was not associated with chronic conditions. Those with lower education and unemployed were more likely to be insomnia sleepers; older adults and retirees were more likely to be nappers.

Conclusion: Findings indicate a heightened risk of chronic conditions involved in suboptimal sleep health phenotypes, mainly insomnia sleepers.

目的确定成年人不同的睡眠健康表型,研究睡眠健康表型随时间的变化,并将其与慢性病风险联系起来:来自美国中年研究的全国成人样本(N = 3,683)提供了两个时间点(T1:2004-2006 年,T2:2013-2017 年)的纵向数据。参与者自我报告了睡眠健康状况(规律性、满意度、警觉性、效率、持续时间)以及慢性疾病的数量和类型。协变量包括年龄、性别、种族、学历、教育程度、伴侣状况、子女数量、工作状况、吸烟、酗酒和体育锻炼:结果:潜伏转换分析确定了两个时间点的四种睡眠健康表型:良好睡眠者、失眠睡眠者、周末补觉者和打盹者。从 T1 到 T2,大多数人(77%)的表型保持不变,其中睡午觉者和失眠者的表型最为稳定。在以两个时间点的良好睡眠者为参照的完全调整模型中,在两个时间点均为失眠睡眠者的人,在调整了第一阶段的情况后,其在第二阶段的慢性病总数增加了 28-81%。在两个时间点都失眠的人罹患心血管疾病、糖尿病、抑郁症和虚弱的风险要高出72%-188%。在任何时间点上都喜欢打盹的人患糖尿病、癌症和虚弱的风险都会增加。周末补觉与慢性病无关。教育程度较低和失业者更有可能失眠;老年人和退休人员更有可能打盹:研究结果表明,亚健康睡眠表型(主要是失眠睡眠者)的慢性病风险增加。
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引用次数: 0
Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers. 对癌症患者及其护理人员的创伤后应激症状和日常睡眠健康的双向调查。
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-01-11 DOI: 10.1097/PSY.0000000000001283
Thomas C Tsai, Hannah-Rose Mitchell, Jamie Zeitzer, Amanda Ting, Jean-Philippe Laurenceau, David Spiegel, Youngmee Kim

Objective: Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related posttraumatic stress symptoms (PTSS) with various sleep markers in this population.

Methods: Patients newly diagnosed with colorectal cancer ( n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months after diagnosis) and their sleep-partner caregivers ( n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived.

Results: Actor-partner interdependence model revealed that caregivers' greater alterations in arousal and reactivity were associated with their own longer SOL ( b = 15.59, p < .001) and their patients' longer sleep duration ( b = 0.61, p = .014), whereas patients' arousal and reactivity were associated with their caregivers' shorter SOL ( b = -8.47, p = .050). Patients' and caregivers' greater negative alterations in cognitions and mood were associated with patients' longer SOL ( b = 9.15, p = .014) and shorter sleep duration ( b = -0.41, p = .050), respectively. Caregivers' greater intrusion was related to their own shorter SOL ( b = -10.14, p = .004).

Conclusions: The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

目的癌症可能是一种创伤性经历,会对患者和护理人员的睡眠产生多方面的影响。本研究探讨了癌症相关创伤后应激症状(PTSS)与该人群中各种睡眠指标的不同关联:新诊断为结肠直肠癌的患者(138 人,平均年龄 56.93 岁,31.88% 为女性,60.14% 为西班牙裔,诊断后 6.53 个月)及其睡眠伴侣照顾者(138 人,平均年龄 55.32 岁,68.12% 为女性,57.97% 为西班牙裔)填写了评估四组 PTSS 的问卷(入侵、回避、唤醒和反应性改变、认知和情绪的负面改变)。参与者还填写了连续 14 天的每日睡眠日记,并从中得出睡眠开始潜伏期(SOL)、睡眠开始后唤醒(WASO)和睡眠持续时间:行为者-伙伴相互依存模型显示,护理者的唤醒和反应性改变较大,这与他们自己较长的SOL(b = 14.54,p < .001)和患者较长的睡眠持续时间(b = 0.47,p = .040)有关,而患者的唤醒和反应性与护理者较短的SOL(b = -8.34,p = .047)和WASO(b = -8.12,p = .019)有关。患者和护理人员在认知和情绪方面的更大负面改变分别与患者更长的SOL(b = 8.89,p = .016)和更短的睡眠时间(b = -0.40,p = .038)相关。护理人员的更大侵扰与他们自身更短的SOL有关(b = -10.92,p = .002):结论:四个PTSS群组,尤其是唤醒和反应性以及负性认知和情绪,与癌症患者和护理人员的个人睡眠指标和夫妻睡眠指标有明显的关联。有必要对这些关系背后的心理社会和生物行为途径进行研究。量身定制的创伤治疗和睡眠干预措施可能会改善这类人群的福祉。
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引用次数: 0
Financial Hardship and Sleep Quality Among Black American Women With and Without Systemic Lupus Erythematosus. 患有和未患有系统性红斑狼疮的美国黑人妇女的经济困境与睡眠质量。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-02-20 DOI: 10.1097/PSY.0000000000001296
Khadijah Abdallah, Shivika Udaipuria, Raphiel Murden, Izraelle I McKinnon, Christy L Erving, Nicole Fields, Reneé Moore, Bianca Booker, Taylor Burey, Charmayne Dunlop-Thomas, Cristina Drenkard, Dayna A Johnson, Viola Vaccarino, S Sam Lim, Tené T Lewis

Objective: To compare dimensions of financial hardship and self-reported sleep quality among Black women with versus without systemic lupus erythematosus (SLE).

Methods: Participants were 402 Black women (50% with validated diagnosis of SLE) living in Georgia between 2017 and 2020. Black women with SLE were recruited from a population-based cohort established in Atlanta, and Black women without SLE were recruited to be of comparable age and from the same geographic areas as SLE women. Financial hardship was measured using three different scales: financial adjustments, financial setbacks, and financial strain. Sleep was assessed continuously using the Pittsburgh Sleep Quality Index (PSQI) scale. Each dimension of financial hardship was analyzed separately in SLE-stratified multivariable linear regression models and adjusted by sociodemographic and health status factors.

Results: Dimensions of financial hardship were similarly distributed across the two groups. Sleep quality was worse in Black women with, versus without, SLE (p < .001). Among Black women with SLE, financial adjustment was positively associated with a 0.40-unit increase in poor sleep quality (95% CI = 0.12-0.67, p = .005). When accounting for cognitive depressive symptoms, financial setbacks and strain were somewhat attenuated for Black women with SLE. Overall, no associations between financial hardships and sleep quality were observed for the women without SLE.

Conclusions: Black women with SLE who experience financial hardships may be more at risk for poor sleep quality than Black women without SLE. Economic interventions targeting this population may help improve their overall health and quality of life.

目的比较患有与未患有系统性红斑狼疮(SLE)的黑人妇女的经济困难程度和自我报告的睡眠质量:参与者为 2017 年至 2020 年间居住在佐治亚州的 402 名黑人女性(其中 50%确诊为系统性红斑狼疮)。患有系统性红斑狼疮的黑人女性是从亚特兰大建立的一个基于人群的队列中招募的,而未患有系统性红斑狼疮的黑人女性则是从与系统性红斑狼疮女性年龄相当、地理位置相同的地区招募的。经济困难采用三种不同的量表进行测量:经济调整、经济挫折和经济压力。使用匹兹堡睡眠质量指数(PSQI)量表对睡眠进行连续评估。在系统性红斑狼疮分层多变量线性回归模型中分别分析了经济困难的各个维度,并根据社会人口学和健康状况因素进行了调整:结果:经济困难的各个维度在两组中的分布相似。患有系统性红斑狼疮的黑人妇女与未患有系统性红斑狼疮的黑人妇女相比,睡眠质量更差(p < .001)。在患有系统性红斑狼疮的黑人女性中,财务调整与睡眠质量差增加 0.40 个单位呈正相关(95% CI = 0.12-0.67, p = .005)。在考虑认知抑郁症状的情况下,患有系统性红斑狼疮的黑人女性的财务挫折和压力有所减轻。总体而言,没有患系统性红斑狼疮的女性在经济困难和睡眠质量之间没有发现任何关联:结论:与没有系统性红斑狼疮的黑人妇女相比,患有系统性红斑狼疮且经济困难的黑人妇女可能更容易出现睡眠质量差的问题。针对这一人群的经济干预措施可能有助于改善她们的整体健康和生活质量。
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引用次数: 0
Optimism and Sleep in Aging Women: Bidirectional Relationships. 老年妇女的乐观情绪与睡眠:双向关系
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-01-09 DOI: 10.1097/PSY.0000000000001281
Addison D Monroe, Stephanie T Judge, Chelsea L Bass, Leslie J Crofford, Suzanne C Segerstrom

Objective: Sleep quality and duration are important for biological restoration and promotion of psychological well-being. Optimism may facilitate or result from sufficient sleep, but questions remain as to directionality. The present study tested how optimism is associated with levels of and variability in sleep quantity and quality in a longitudinal burst design.

Methods: Midlife and older women ( N = 199) reported their sleep quantity and quality in online diaries for a 7-day period, every 3 months for 2 years. Optimism was measured at baseline and end-of-study. Multilevel models tested the effects of optimism on sleep. Linear regression models tested the effect of sleep on optimism.

Results: Baseline optimism was associated with higher sleep quality ( γ = 2.13 [1.16 to 3.11], p < .0001) and lower intraindividual variability (IIV; night-to-night and wave-to-wave) in sleep quantity (night-to-night: γ = -0.07 [-0.13 to -0.005], p = .03; wave-to-wave: b = -0.07 [-0.12 to -0.02], p = .003). In turn, higher average sleep quality (but not quantity) was associated with higher optimism at end-of-study ( b = 0.02 [0.007 to 0.03], p = .002). Variability in sleep was unrelated to optimism.

Conclusions: Optimism may play an important role in maintaining sleep quality and consistency in sleep quantity, perhaps by buffering stress. Similarly, sleep quality may play an important role in maintaining optimism. The cycle whereby optimism and sleep enhance one another could improve physical health and psychological well-being among aging adults.

目的:睡眠质量和持续时间对生物恢复和促进心理健康非常重要。乐观可能会促进充足的睡眠,也可能是充足睡眠的结果,但其方向性仍存在疑问。本研究采用纵向突变设计,测试了乐观情绪与睡眠数量和质量的水平及变化之间的关系:方法:中老年妇女(199 人)在两年内每 3 个月通过在线日记报告其 7 天的睡眠数量和质量。乐观情绪在基线和研究结束时进行测量。多层次模型检验了乐观情绪对睡眠的影响。线性回归模型测试了睡眠对乐观情绪的影响:结果:基线乐观情绪与较高的睡眠质量(γ = 2.13 [1.16, 3.11],p < .0001)和较低的睡眠量个体内变异性(IIV;夜间和波间)相关(夜间:γ = -0.07 [-0.13, -0.005],p = .03;波间:b = -.07 [-.12, -.02], p = .003)。反过来,较高的平均睡眠质量(而非数量)与研究结束时较高的乐观程度相关(b = .02 [.007, .03], p = .002)。睡眠的不稳定性与乐观情绪无关:结论:乐观情绪在保持睡眠质量和睡眠数量的一致性方面可能起着重要作用,也许可以缓冲压力。同样,睡眠质量也可能在维持乐观情绪方面发挥重要作用。乐观情绪和睡眠相互促进的循环可以改善老年人的身体健康和心理健康。
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引用次数: 0
Bidirectional Associations Between Loneliness, Emotional Support, and Sleep in Daily Life. 日常生活中孤独感、情感支持和睡眠之间的双向联系
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-02-19 DOI: 10.1097/PSY.0000000000001291
Kristina D Dickman, Mark C Thomas, Brian N Chin, Thomas W Kamarck

Objective: Evidence suggests a link between positive social relationship perceptions and improved sleep (e.g., quality, efficiency) across the life span. Less work has probed the directionality of these relationships. Here, we report findings from the first study to examine bidirectional between- and within-person associations between loneliness and emotional support with daily life measures of sleep.

Methods: Participants were 389 healthy adults aged 40 to 64 years (61% female) who completed hourly surveys assessing loneliness and perceptions of emotional support over the course of 4 days. Measures of actigraphy-assessed sleep and nightly sleep quality were also assessed for 7 to 10 days.

Results: Individuals with lower average daily loneliness showed higher sleep quality and efficiency than individuals with higher loneliness (r = -0.19, p < .001; r = -0.14, p = .008, respectively), and greater average emotional support was likewise linked with better sleep quality (r = 0.18, p < .001). Controlling for neuroticism attenuated the effects of average loneliness on sleep. Within-person analyses showed unexpected bidirectional effects. Specifically, days in which people felt relatively lonelier were followed by nights with greater sleep efficiency (γ = 1.08, p = .015), and nights when people reported relatively poorer sleep quality were followed by days with greater emotional support (γ = -0.04, p = .013). These unexpected findings are probed in exploratory analyses.

Conclusions: Individuals with higher loneliness and lower emotional support report poorer sleep quality and efficiency, on average. Day-to-day fluctuations in perceptions of social relationships may affect the following night's sleep, and vice versa.

目的:有证据表明,在人的一生中,积极的社会关系感知与睡眠改善(如质量、效率)之间存在联系。但较少研究这些关系的方向性。在此,我们报告了第一项研究的结果,该研究探讨了孤独感和情感支持与日常生活中的睡眠测量之间的双向人际关系和人内关系:参与者为 389 名 40 至 64 岁的健康成年人(61% 为女性),他们在 4 天内每小时完成一次调查,评估孤独感和对情感支持的感知。此外,他们还在 7 到 10 天内对动电仪评估的睡眠和夜间睡眠质量进行了评估:结果:平均每天孤独感较低的人比孤独感较高的人显示出更高的睡眠质量和效率(r = -0.19,p < .001;r = -0.14,p = .008),平均情感支持较高的人同样与更好的睡眠质量相关(r = 0.18,p < .001)。控制神经质会减弱平均孤独感对睡眠的影响。人内分析显示了意想不到的双向效应。具体来说,在人们感到相对孤独的日子里,其后的夜晚睡眠效率较高(γ = 1.08,p = .015);在人们报告睡眠质量相对较差的夜晚,其后的日子情感支持较强(γ = -0.04,p = .013)。这些意想不到的结果将在探索性分析中进行探讨:结论:孤独感较强和情感支持较弱的人平均睡眠质量和效率较差。对社会关系看法的日常波动可能会影响第二天晚上的睡眠,反之亦然。
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引用次数: 0
Prospective Bidirectional Relationship Between Sleep Duration and Posttraumatic Stress Disorder Symptoms After Suspected Acute Coronary Syndrome. 疑似急性冠状动脉综合征后睡眠时间与创伤后应激障碍症状之间的前瞻性双向关系
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-01-06 DOI: 10.1097/PSY.0000000000001279
Talea Cornelius, Donald Edmondson, Marwah Abdalla, Allie Scott, Brandon Fernandez Sedano, David Hiti, Alexandra M Sullivan, Joseph E Schwartz, Ian M Kronish, Ari Shechter

Objective: Sleep disturbance is a "hallmark" symptom of posttraumatic stress disorder (PTSD). Poor sleep (including short sleep) after combat-related trauma can also predict subsequent PTSD. Less is known about the association between sleep duration and PTSD symptoms when PTSD is induced by acute coronary syndrome (ACS). We examined the bidirectional relationship between sleep duration and PTSD symptoms over the year after hospital evaluation for ACS.

Methods: Participants were enrolled in this observational study after emergency department evaluation for ACS. Sleep duration ("During the past month, how many hours of actual sleep did you get at night?") and cardiac event or hospitalization-induced PTSD symptoms (PTSD Checklist) were assessed at 1, 6, and 12 months after hospital discharge. Cross-lagged path analysis was used to model the effects of sleep duration and PTSD symptoms on each other. Covariates included age, sex, race/ethnicity, cardiac severity, baseline depression symptoms, and early acute stress disorder symptoms.

Results: The sample included 1145 participants; 16% screened positive for probable PTSD (PTSD Checklist score ≥33). Mean sleep duration across time points was 6.1 hours. Higher PTSD symptoms predicted shorter sleep duration at the next time point (i.e., 1-6 and 6-12 months; B = -0.14 hours/10-point difference, SE = 0.03, p < .001). Shorter sleep duration was associated with higher PTSD symptoms at the next time point (B = -0.25 points/hour, SE = 0.12, p = .04).

Conclusions: Short sleep duration and PTSD symptoms are mutually reinforcing across the first year after ACS evaluation. Findings suggest that sleep, PTSD symptoms, and their relationship should be considered in the post-ACS period.

目的:睡眠障碍是创伤后应激障碍(PTSD)的 "标志性 "症状:睡眠障碍是创伤后应激障碍(PTSD)的 "标志性 "症状。与战斗有关的创伤后睡眠不佳(包括睡眠时间短)也可预示随后的创伤后应激障碍。当急性冠状动脉综合征(ACS)诱发创伤后应激障碍时,人们对睡眠时间与创伤后应激障碍症状之间的关系知之甚少。我们研究了急性冠状动脉综合征住院评估后一年内睡眠时间与创伤后应激障碍症状之间的双向关系:方法:在急诊科对急性冠状动脉综合征进行评估后,参与者被纳入这项观察性研究。在出院后的 1、6 和 12 个月对睡眠时间("在过去一个月中,您晚上实际睡眠时间为多少小时?")和心脏事件或住院诱发的创伤后应激障碍症状(创伤后应激障碍清单)进行评估。交叉滞后路径分析用于模拟睡眠时间和创伤后应激障碍症状之间的相互影响。协变量包括年龄、性别、种族/民族、心脏严重程度、基线抑郁症状和早期急性应激障碍症状:样本包括 1145 名参与者,其中 16% 的人可能患有创伤后应激障碍(创伤后应激障碍检查表得分≥33)。各时间点的平均睡眠时间为 6.1 小时。创伤后应激障碍症状越严重,则下一个时间点的睡眠时间越短(即 1-6 个月和 6-12 个月;B = -0.14 小时/10 点差异,SE = 0.03,p < .001)。睡眠时间较短与下一个时间点的创伤后应激障碍症状较重有关(B = -0.25 分/小时,SE = 0.12,P = .04):结论:在 ACS 评估后的第一年中,睡眠时间短和创伤后应激障碍症状是相互促进的。研究结果表明,在接受 ACS 评估后的一年中,应考虑睡眠、创伤后应激障碍症状以及它们之间的关系。
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引用次数: 0
The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes. 非裔美国 2 型糖尿病成人的多维睡眠健康与 HbA1c 和抑郁症状的关系。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1097/PSY.0000000000001298
Jihun Woo, H Matthew Lehrer, Doonya Tabibi, Lauren Cebulske, Hirofumi Tanaka, Mary Steinhardt

Objective: Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes.

Methods: Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms.

Results: Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c.

Conclusions: Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population.

Trial registry: ClinicalTrials.gov identifier NCT04282395.

目的睡眠对糖尿病相关的健康结果非常重要。我们采用多维睡眠健康框架,研究了患有 2 型糖尿病的非裔美国成年人中,单个睡眠健康维度和综合睡眠健康评分与血红蛋白 A1c(HbA1c)和抑郁症状之间的关系:通过当地教会招募参与者(N = 257;平均年龄 = 62.5 岁)。腕戴式动作仪和睡眠问卷数据采用 RuSATED 框架(规律性、满意度、警觉性、时间性、效率、持续时间)评估多维睡眠健康状况。单个睡眠维度被二分为睡眠健康状况差或好,并加总为综合得分。使用 DCA Vantage™ Analyzer 或 A1CNow® Self Check 对 HbA1c 进行评估。抑郁症状采用患者健康问卷(PHQ-9)进行评估。回归模型检验了单个睡眠维度和综合睡眠健康状况与 HbA1c 和抑郁症状之间的关联:结果:较高的综合睡眠健康得分与较低的抑郁症状(PHQ-9 ≥ 5)相关(几率比 [OR] = 0.578,95% 置信区间 [CI] = 0.461-0.725)。包括睡眠不规律(OR = 1.013,CI = 1.005-1.021)、满意度差(OR = 3.130,CI = 2.095-4.678)和警觉性较低(OR = 1.866,CI = 1.230-2.833)在内的几个单个睡眠维度与抑郁症状的可能性增加有关。睡眠健康综合评分或单个睡眠维度均与 HbA1c 无关:结论:在患有 2 型糖尿病的非裔美国成年人中,较好的多维睡眠健康与较低的抑郁症状相关。需要进行纵向研究,以确定这一人群中多维睡眠健康与抑郁症状之间的因果关系:试验登记:ClinicalTrials.gov 标识符 NCT04282395。
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引用次数: 0
All Issue Ads. 所有发行广告。
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1097/01.psy.0001022952.58186.e3
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引用次数: 0
Association Between Global Sleep Quality and Coronary Microvascular Function in Male Physicians With Occupational Burnout. 职业倦怠男性医师整体睡眠质量与冠状动脉微血管功能的关系
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2023-11-17 DOI: 10.1097/PSY.0000000000001269
Roland von Känel, Mary Princip, Sarah A Holzgang, Alexia Rossi, Andreas A Giannopoulos, Ronny R Buechel, Claudia Zuccarella-Hackl, Aju P Pazhenkottil

Objective: Occupational burnout has been associated with an increased risk of coronary heart disease, although the mechanisms involved are elusive. We investigated whether poor global sleep quality is associated with impaired coronary microvascular function in male physicians, a professional group at increased risk of burnout.

Methods: Study participants were 30 male physicians with clinical burnout and 30 controls without burnout defined by the Maslach Burnout Inventory. Global sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular functions were quantified with myocardial perfusion positron emission tomography. In multivariable analyses, the interaction between burnout and the PSQI global score was regressed on measures of coronary microvascular function, adjusting for age, body mass index, physical activity, alcohol consumption, and main effects of burnout and PSQI score.

Results: The prevalence of poor sleepers (PSQI score >5) was 40% in the burnout group and 10% in the control group. Adjusting for covariates, burnout-by-global PSQI score interactions were observed for myocardial blood flow (MBF) at rest ( r partial = -0.30, p = .025), endothelium-dependent coronary flow reserve ( r partial = -0.26, p = .062), MBF response ( r partial = -0.30, p = .028), and hyperemic MBF ( r partial = -0.34, p = .012). The global PSQI score was inversely associated with these MBF measures in the burnout group relative to the control group. No significant interactions emerged for endothelium-independent MBF.

Conclusions: In male physicians with occupational burnout, poor global sleep quality was associated with reduced endothelium-dependent coronary microvascular function, suggesting a mechanism by which burnout may affect cardiovascular health.

目的:职业倦怠与冠心病风险增加有关,但其机制尚不明确。我们调查了男性医生整体睡眠质量差是否与冠状动脉微血管功能受损有关,这是一个职业群体,倦怠风险增加。方法:研究对象为30名有临床职业倦怠的男性医生和30名没有职业倦怠的对照组(由Maslach职业倦怠量表定义)。采用匹兹堡睡眠质量指数(PSQI)测量全球睡眠质量。心肌灌注正电子发射断层扫描定量检测内皮依赖性(冷压试验)和内皮非依赖性(腺苷挑战)冠状动脉微血管功能。在多变量分析中,通过冠状动脉微血管功能测量、年龄、体重指数、体力活动、酒精消耗以及倦怠和PSQI评分的主要影响,对倦怠与PSQI总分之间的相互作用进行了回归。结果:倦怠组睡眠质量差(PSQI评分bb50)发生率为40%,对照组为10%。调整协变量后,观察到静息时心肌血流量(MBF)与总体PSQI评分的相互作用(r偏= -)。30, p = 0.025),内皮依赖性冠状动脉血流储备(r偏= -。26, p = 0.062), MBF反应(r偏= -。30, p = 0.028)和充血性MBF (r偏= -)。34, p = - 0.012)。与对照组相比,倦怠组整体PSQI得分与MBF测量呈负相关。不依赖内皮的MBF没有明显的相互作用。结论:在职业倦怠的男性医生中,整体睡眠质量差与内皮依赖性冠状动脉微血管功能降低有关,提示职业倦怠可能影响心血管健康的机制。
{"title":"Association Between Global Sleep Quality and Coronary Microvascular Function in Male Physicians With Occupational Burnout.","authors":"Roland von Känel, Mary Princip, Sarah A Holzgang, Alexia Rossi, Andreas A Giannopoulos, Ronny R Buechel, Claudia Zuccarella-Hackl, Aju P Pazhenkottil","doi":"10.1097/PSY.0000000000001269","DOIUrl":"10.1097/PSY.0000000000001269","url":null,"abstract":"<p><strong>Objective: </strong>Occupational burnout has been associated with an increased risk of coronary heart disease, although the mechanisms involved are elusive. We investigated whether poor global sleep quality is associated with impaired coronary microvascular function in male physicians, a professional group at increased risk of burnout.</p><p><strong>Methods: </strong>Study participants were 30 male physicians with clinical burnout and 30 controls without burnout defined by the Maslach Burnout Inventory. Global sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular functions were quantified with myocardial perfusion positron emission tomography. In multivariable analyses, the interaction between burnout and the PSQI global score was regressed on measures of coronary microvascular function, adjusting for age, body mass index, physical activity, alcohol consumption, and main effects of burnout and PSQI score.</p><p><strong>Results: </strong>The prevalence of poor sleepers (PSQI score >5) was 40% in the burnout group and 10% in the control group. Adjusting for covariates, burnout-by-global PSQI score interactions were observed for myocardial blood flow (MBF) at rest ( r partial = -0.30, p = .025), endothelium-dependent coronary flow reserve ( r partial = -0.26, p = .062), MBF response ( r partial = -0.30, p = .028), and hyperemic MBF ( r partial = -0.34, p = .012). The global PSQI score was inversely associated with these MBF measures in the burnout group relative to the control group. No significant interactions emerged for endothelium-independent MBF.</p><p><strong>Conclusions: </strong>In male physicians with occupational burnout, poor global sleep quality was associated with reduced endothelium-dependent coronary microvascular function, suggesting a mechanism by which burnout may affect cardiovascular health.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"216-226"},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Heart Rate Variability Buffers the Effect of Attachment Insecurity on Sleep Quality. 高心率变异性可缓冲依恋不安全感对睡眠质量的影响。
IF 3.3 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-01 Epub Date: 2024-03-04 DOI: 10.1097/PSY.0000000000001295
Jensine Paoletti-Hatcher, Daniel L Argueta, E Lydia Wu-Chung, Michelle A Chen, Ryan L Brown, Angie S LeRoy, Kyle W Murdock, Julian F Thayer, Christopher P Fagundes

Objective: Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment anxiety is reliably associated with adverse health outcomes, whereas high attachment avoidance is associated with adverse health outcomes when co-occurring with poor self-regulatory capacity, indexed by heart rate variability (HRV). We examined the associations between attachment anxiety, attachment avoidance, HRV, and sleep quality.

Methods: Using longitudinal data from a sample of 171 older adults measured four times over 1 year ( M = 66.18 years old; 67.83% women), we separated the between-person variance (which we call "trait") and within-person variance (which we call "state") for attachment anxiety, attachment avoidance, and HRV (via the root mean square of successive differences). Sleep quality was measured with the Pittsburgh Sleep Quality Index.

Results: Higher trait attachment anxiety was associated with poorer global sleep quality ( B = 0.22, p = .005). Higher state attachment avoidance was associated with poorer sleep quality ( B = -0.13, p = .01), except for those with higher trait HRV. Higher state attachment anxiety was associated with poorer sleep quality ( B = -0.15, p = .002), except for those with higher or mean trait HRV. Higher trait attachment anxiety was associated with poorer sleep quality ( B = -0.31, p = .02), except for those with higher trait HRV.

Conclusions: High trait HRV mitigated the adverse effects of attachment insecurity on sleep quality. Our results suggest that people with high trait HRV had greater self-regulation capacity, which may enable them to enact emotion regulation strategies effectively.

目的:睡眠质量是重要的健康保护因素:睡眠质量是一个重要的健康保护因素。包括依恋取向在内的社会心理因素对于了解哪些人有睡眠质量差和相关不良健康后果的风险可能很有价值。高度依恋焦虑与不良健康后果有可靠的相关性,而高度依恋回避与不良自我调节能力(以心率变异性(HRV)为指标)同时存在时,则与不良健康后果相关。我们研究了依恋焦虑、依恋回避、心率变异和睡眠质量之间的关联:利用对 171 名老年人(男 = 66.18 岁;67.83% 为女性)一年内进行四次测量的纵向数据,我们分离了依恋焦虑、依恋回避和心率变异的人际变异(我们称之为 "特质")和人内变异(我们称之为 "状态")(通过连续差异的均方根)。睡眠质量通过匹兹堡睡眠质量指数进行测量:结果:特质依恋焦虑越高,整体睡眠质量越差(B = 0.22,p = .005)。较高的状态依恋回避与较差的睡眠质量有关(B = -0.13,p = .01),特质心率变异较高的人除外。较高的状态依恋焦虑与较差的睡眠质量有关(B = -0.15,p = .002),但特质心率变异较高或平均的人除外。特质依恋焦虑越高,睡眠质量越差(B = -0.31,p = .02),特质心率变异越高的人除外:结论:高特质心率变异减轻了依恋不安全感对睡眠质量的不利影响。我们的研究结果表明,特质心率变异高的人具有更强的自我调节能力,这可能使他们能够有效地实施情绪调节策略。
{"title":"High Heart Rate Variability Buffers the Effect of Attachment Insecurity on Sleep Quality.","authors":"Jensine Paoletti-Hatcher, Daniel L Argueta, E Lydia Wu-Chung, Michelle A Chen, Ryan L Brown, Angie S LeRoy, Kyle W Murdock, Julian F Thayer, Christopher P Fagundes","doi":"10.1097/PSY.0000000000001295","DOIUrl":"10.1097/PSY.0000000000001295","url":null,"abstract":"<p><strong>Objective: </strong>Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment anxiety is reliably associated with adverse health outcomes, whereas high attachment avoidance is associated with adverse health outcomes when co-occurring with poor self-regulatory capacity, indexed by heart rate variability (HRV). We examined the associations between attachment anxiety, attachment avoidance, HRV, and sleep quality.</p><p><strong>Methods: </strong>Using longitudinal data from a sample of 171 older adults measured four times over 1 year ( M = 66.18 years old; 67.83% women), we separated the between-person variance (which we call \"trait\") and within-person variance (which we call \"state\") for attachment anxiety, attachment avoidance, and HRV (via the root mean square of successive differences). Sleep quality was measured with the Pittsburgh Sleep Quality Index.</p><p><strong>Results: </strong>Higher trait attachment anxiety was associated with poorer global sleep quality ( B = 0.22, p = .005). Higher state attachment avoidance was associated with poorer sleep quality ( B = -0.13, p = .01), except for those with higher trait HRV. Higher state attachment anxiety was associated with poorer sleep quality ( B = -0.15, p = .002), except for those with higher or mean trait HRV. Higher trait attachment anxiety was associated with poorer sleep quality ( B = -0.31, p = .02), except for those with higher trait HRV.</p><p><strong>Conclusions: </strong>High trait HRV mitigated the adverse effects of attachment insecurity on sleep quality. Our results suggest that people with high trait HRV had greater self-regulation capacity, which may enable them to enact emotion regulation strategies effectively.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":" ","pages":"349-358"},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Psychosomatic Medicine
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