音乐疗法对应激性失眠易感人群唤醒度的影响

摘要

Objective To explore the arousal of people with high stress-related sleep vulnerability and the effect of music intervention on hyperarousal.Methods A total of 33 healthy subjects from China Rehabilitation Research Center were enrolled in this study.Based on the median value (17 score) of Ford Insomnia Response to Stress Test-Chinese Version (FIRST-C),they were divided into 2 groups:16 cases of high stress-related sleep vulnerability and 17 cases of low stress-related sheep vulnerability.Multiparameter physiological indexes monitoring system of Thought Technology Ltd.was used to gather physiological indicators [blood volume pulse (BVP),skin temperature,skin conduction,respiration rate,respiration amplitude and heart rate],and brain wave [δ wave,θ wave,low α wave and high α wave,α wave,sensory-motor rhythm (SMR),low β wave and high β wave].Results Compared with low vulnerability subjects,high vulnerability subjects had significantly higher skin conduction (P =0.003,0.001),amplitude of SMR (P =0.015.0.031) and low β wave (P =0.000,0.001) before and after treatment,while had significantly increased high β wave after treatment (P =0.004).After treatment,all subjects had significantly reduced BVP (P =0.000),increased skin temperature (P =0.000),increased respiration rate (P =0.008) and reduced heart rate (P =0.000).Compared with before treatment,high vulnerability subjects had significantly reduced skin conduction (P =0.001),respiratory amplitude (P =0.032),high α wave (P =0.017) and low β wave (P =0.013) after treatment.Compared with before treatment,low vulnerability subjects had significantly reduced skin conduction (P =0.039),low α wave (P =0.035),high α wavc (P =0.031),α wave (P =0.044) and low β wave (P =0.015) after treatment.Conclusions Both physiological and cortical hyperarousal are presented in people with high stress-related sleep vulnerability in resting state.Music intervention can improve the hyperarousal of high vulnerability people,especially their physiological indicators.It can be used as a health management technique to prevent people with high stress-related sleep vulnerability from developing into chronic insomnia.%目的 探讨应激性失眠易感人群的高唤醒机制及音乐疗法对其唤醒度的影响.方法 选择中国康复研究中心北京博爱医院的健康医护人员33人,根据福特应激失眠反应测验量表中文版(FIRST-C)中位值(17分)分为易感组(16人)和非易感组(17人),采用加拿大Thought Technology公司生产的多参数生理指标监测系统采集一般生理指标(包括指端脉搏血容振幅、皮温、皮肤电传导、呼吸频率和波幅、心率)以及脑电波[包括δ波、θ波、低波幅和高波幅α波、α波、感觉运动节律(SMR)、低波幅和高波幅β波]:结果 与非易感组相比,易感组受试者治疗前后皮肤电传导升高(P=0.003,0.001)、SMR波幅升高(P=0.015,0.031)和低波幅β波波幅升高(P=0.000,0.001),仅治疗后高波幅β波波幅升高(P=0.004);与治疗前相比,治疗后两组受试者指端脉搏血容振幅降低(P=0.000)、皮温升高(P=0.000)、呼吸频率增加(P=0.008)、心率减少(P=0.000),以及易感组皮肤电传导降低(P=0.001)、呼吸波幅降低(P=0.032)、高波幅d波(P=0.017)和低波幅β波(P=0.013)波幅降低,非易感组皮肤电传导降低(P=0.039)、低波幅(P=0.035)和高波幅(P=0.031)α波波幅降低、α波波幅降低(P=0.044)、低波幅β波波幅降低(P=0.015).结论 平静状态下应激性失眠易感人群生理和皮质均表现出高唤醒趋势;音乐疗法可以降低其高唤醒机制,尤以生理指标改善显著,可以作为健康管理手段,预防应激性失眠易感人群进展为慢性失眠.