睡眠呼吸暂停综合征与肺高血压

肺高血压是一类以肺血管阻力进行性升高为主要特征,并最终导致右心衰竭甚至死亡的恶性心血管疾病.多种疾病可导致肺高血压,其中第三大类肺高血压与肺部疾病及缺氧有关.已有许多研究得出结论睡眠呼吸暂停综合征是肺高血压的高危因素,但具体发病机制不详.本文目的是结合国外文献阐述睡眠呼吸暂停综合征致肺高血压的发病机制及干预睡眠呼吸暂停综合征对肺动脉高压的影响.     

Melatonin and Sleep Qualities in Healthy Adults: Pharmacological and Expectancy Effects

The impact of expectancy on melatonin's effects on sleep qualities was investigated. Both the pharmacological dose of 6 mg of melatonin and the expectation of receiving melatonin were predicted to improve subjective ratings of sleep qualities. The balanced placebo design varied 2 factors within-subjects: actual treatment and expected treatment. Adults (N = 53; 21 men and 32 women) between the ages of 26 and 71 years were administered either 6 mg of melatonin or a placebo for 8 nights. An instructional manipulation directed participants' expectations. Participants rated their nightly sleep experiences. Results revealed that feelings upon awakening differed between genders and that expecting melatonin increased ratings of sleep continuity. Most important, high ratings of “grogginess/tiredness” were associated with receiving melatonin, regardless of expectancy, as well as with receiving placebo when melatonin was expected. Overall, the findings underscore the need to consider expectancy and gender differences in research on melatonin and sleep experiences.     

Depression and pain in night time and daytime functioning of individuals with lupus

The purpose of this study was to investigate the role of pain and depression in night time and daytime functioning of individuals with lupus. A cross-sectional research design was used. Participants were recruited via a mail-out to members of the Lupus Australia Foundation and the Lupus Association of New South Wales. One hundred and fifty-four participants completed a questionnaire package consisting of a Lupus Medical and Symptoms Questionnaire designed by the researchers, the Cardiac Depression Scale and the Pittsburgh Sleep Quality Index. Hierarchical regression analyses revealed that pain principally predicted levels of sleep disturbance, whilst depression and pain (to a lesser extent) together predicted daytime dysfunction. The present results suggested the need for more adequate pain management, particularly at night and psychological interventions to decrease levels of depression that interfere with daily functioning in individuals with lupus.     

Self-control depletion and sleep duration: the mediating role of television viewing

Abstract

Objective: Sleep insufficiency has been related to self-control failure: people fail to go to bed in time and end up sleep deprived. The role of state self-control in predicting bedtime and sleep duration has not yet been investigated. Based on research claiming an overlap between depleted self-control resources and fatigue, self-control depletion may foster earlier bedtimes. Conversely, self-control depletion also increases the propensity to procrastinate bedtime by giving in to the immediate gratification of late night entertainment. This study therefore looked at procrastinatory television viewing and its intermediary role in the association between state self-control and bedtime. The implications for sleep duration are examined. Design: Firstyear students (N = 234) participated in an online survey. Using Day Reconstruction Method, they charted their activities and experiences during the preceding day and subsequent bedtime behavior. Results: Self-control depletion was directly related to earlier bedtimes, which we explained by its similarity to fatigue. This was associated with longer sleep duration. Self-control depletion was indirectly related to later bedtimes because it increased the propensity to procrastinate by watching television. This was associated with shorter sleep duration. Conclusion: This study exposes a dual pathway between self-control depletion and sleep duration, whereby procrastinatory television viewing may reduce sleep duration.     

Existe-t-il une typologie familiale dans les pathologies addictives ? Revue critique de la littérature sur les familles d’adolescents présentant des troubles alimentaires ou des conduites de dépendance aux substances

Among factors favoring the addictive behaviors, some specific family processes are often identified in eating disorders and dependences with psychoactive substances. Different models of systemic orientation described the familial disturbances involved in the addictive pathologies emphasizing either the emotional interaction and the processes of differentiation family, either the structure and the level of family cohesion. This article proposes a critical review of the systemic literature on the familial disturbances involved in the families of adolescents with eating disorders or with a substance-dependence. The systemic models (Bowen, Minuchin) are reference values in the understanding of family processes and therapy with families. The observations of these family processes have been confronted to empirical researches integrating different epistemological levels and different methods. The empirical results are heterogenous concerning the different forms of family functioning associated with these addictive pathologies. The empirical studies support the hypothesis of a family dysfunctioning in the different addictive behaviors and demonstrate the relationship between the severity of familial disorders and the severity of the addictive disorders. However, the family configuration described by the typological models is rarely found complete or with a similar intensity between the families. The studies support the hypothesis of an emotional distance in the family interactions and a lack of parental care which could correspond to factors of chronicity or vulnerability. Comparing the family characteristics of these two types of addictive behaviors, the literature supports the existence of (1) some specific family characteristics according to the type of addictive behavior (in particular the conflict avoidance which appears specifically in anorexic families) (2) some similar family patterns of interactions between the members of addictive families in particular the representation of a low family cohesion, an intergenerational enmeschment and a high level of control. These family patterns suggest rather to a dimensional approach of the family characterized by different protective or risk factors. We suggest that these family patterns could constitute, according to their importance (intensity and frequence), a family risk factor of development or aggravation of the addictive behaviors.     

NonREM sleep mentation in chronically-treated persons with schizophrenia

This study examined the laboratory dream content reported by 14 patients with schizophrenia and 15 controls, with a focus on reports obtained from NonREM sleep. Both the controls' and patients' frequency of dream recall following awakenings from NonREM and REM sleep were similar to values reported for healthy participants. Patients' NonREM sleep narratives were shorter than those from controls. When compared to their reports from REM sleep, both groups' NonREM sleep reports included significantly fewer words and reportable items. The controls were more likely to report a subjective feeling of bizarreness for their REM sleep reports as compared to their NonREM sleep reports. This difference was not observed in patients with schizophrenia. Taken together, these findings suggest few differences between the NonREM sleep mentation of patients with schizophrenia and of controls and that sleep stage cognitive style is comparable in both groups, with NonREM sleep reports being more thought-like, less elaborate and bizarre than REM sleep reports.     

What subjective experiences determine the perception of falling asleep during sleep onset period?

Sleep onset is associated with marked changes in behavioral, physiological, and subjective phenomena. In daily life though subjective experience is the main criterion in terms of which we identify it. But very few studies have focused on these experiences. This study seeks to identify the subjective variables that reflect sleep onset. Twenty young subjects took an afternoon nap in the laboratory while polysomnographic recordings were made. They were awakened four times in order to assess subjective experiences that correlate with the (1) appearance of slow eye movement, (2) initiation of stage 1 sleep, (3) initiation of stage 2 sleep, and (4) 5 min after the start of stage 2 sleep. A logistic regression identified control over and logic of thought as the two variables that predict the perception of having fallen asleep. For sleep perception, these two variables accurately classified 91.7% of the cases; for the waking state, 84.1%.     

小学生创伤后应激障碍对睡眠问题的影响:积极认知的调节作用

本研究采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、应对方式问卷和儿童行为问题核查表对汶川地震30个月后844名小学生进行调查,探讨汶川地震后小学生的创伤后应激障碍(PTSD)、积极认知与睡眠问题之间的关系。结果表明,PTSD对睡眠问题具有正向预测作用,积极认知对睡眠问题的预测作用不显著。调节效应的检验结果发现,积极认知调节着PTSD及其回避性症状对睡眠问题的影响,具体表现为PTSD及其回避性症状对睡眠问题的预测作用随着积极认知水平的增加而降低,但是积极认知分别在PTSD的闯入性症状和警觉性增高症状与睡眠问题的关系之间不起调节作用。     

Daydreams and nap dreams: Content comparisons

Differences between nighttime REM and NREM dreams are well-established but only rarely are daytime REM and NREM nap dreams compared with each other or with daydreams. Fifty-one participants took daytime naps (with REM or NREM awakenings) and provided both waking daydream and nap dream reports. They also provided ratings of their bizarreness, sensory experience, and emotion intensity. Recall rates for REM (96%) and NREM (89%) naps were elevated compared to typical recall rates for nighttime dreams (80% and 43% respectively), suggesting an enhanced circadian influence. All attribute ratings were higher for REM than for NREM dreams, replicating findings for nighttime dreams. Compared with daydreams, NREM dreams had lower ratings for emotional intensity and sensory experience while REM dreams had higher ratings for bizarreness and sensory experience. Results support using daytime naps in dream research and suggest that there occurs selective enhancement and inhibition of specific dream attributes by REM, NREM and waking state mechanisms.     

Sleep Leadership in High-Risk Occupations: An Investigation of Soldiers on Peacekeeping and Combat Missions

Individuals in high-risk occupations (e.g., military service) often report physical, psychological, and organizational problems. Although leaders can partially buffer their subordinates against these problems, the impact of established leadership skills appears limited, especially in high-risk occupations. Thus, building on recent theories of domain-specific leadership, we examined whether leadership focused on the specific domain of sleep might be negatively associated with some specific problems facing individuals in high-risk occupations, beyond their relationship with general leadership. Studying military personnel on peacekeeping and combat deployments, we predicted that “sleep leadership” would be negatively associated with sleep problems (physical), depressive symptoms (psychological), and negative climate (organizational), and that sleep would mediate the relationship between sleep leadership and the psychological and organizational problems. Results were generally supportive, contributing to theories of domain-specific leadership by showing that sleep-focused leader behaviors may go beyond general leadership behaviors, relating directly to the problems facing individuals in high-risk occupations.