| Background:The incidence of insomnia is high but the cure rate is low,because the complex disease mechanism is not fully understood.Studies have shown that melatonin is the most commonly used and powerful marker of human circadian rhythm,and its relationship with cortisol is also a hot topic of recent research.Previous studies have shown that melatonin and cortisol are a pair of antagonistic hormones,that is,the phase of melatonin secretion is opposite to that of cortisol.However,there are few studies on the combination of cortisol and melatonin in patients with chronic insomnia.Objective:To explore the rhythmic changes of serum melatonin and cortisol in CID patients and their effects on sleep.Methods:Thirty-six patients were collected,and 27 healthy people without sleep disorder during outpatient physical examination during the same period were selected as the control group（HC）.Insomnia severity index scale（ISI）,Chinese Beijing version of Montreal cognitive assessment scale（Mo CA-C）,Pittsburgh sleep quality index scale（PSQI）,17-item Hamilton depression scale（HAMD-17）were used to evaluate the overall quality of patients Cognitive function,sleep quality,and emotional status were assessed using the Chinese version of the Perception of Stress Scale（CPSS）,the Bedtime Arousal State Scale（PSA）,and the Chinese version of the Ford Stress Response Scale（FIRST-C）.Insomnia susceptibility.In the sleep monitoring room,polysomnography（PSG）was used to collect and record objective sleep conditions throughout the night,including total sleep time（TST）,sleep latency（SOL）,sleep efficiency（SE）,and non-rapid eye movement（NREM）sleep.Structure（percentage of total sleep time in stages 1,2 and 3,namely N1,N2,N3）and structure of REM sleep stage（time in REN stage and percentage of total sleep time,namely REM）,etc.The subjects’ venous blood was drawn from 22:00-00:00 before going to bed,4:00-6:00 the next morning when they woke up for the last time,and around 8:00after getting up in the morning and stored.The serum levels of serum markers COR,CRH and MLT were detected by enzyme-linked immunosorbent assay（ELISA）.Results:（1）Background information: Only the age index of the patients was statistically different,and the CID group was slightly older（t=2.167,p=0.034）;other height,weight and BMI indexes were not statistically different（all p>0.05）.Compared with the HC group,the patients in the CID group had higher PSQI scores（t=13.211,p<0.01）and higher ISI scores（t=17.867,p<0.01）,and the difference was statistically significant.Compared with HC group,patients in CID group had higher FIRST score（t=11.146,p<0.01）,higher CPSS score（t=9.264,p<0.01）,and higher PSAS score（t=9.585,p<0.01）0.01),higher PSASB score（t=9.288,p<0.01）and higher PSASC score（t=4.781,p<0.01）,the difference was statistically significant.（2）Serological indicators: Compared with the HC group,the patients in the CID group only had a higher average level of COR2 among the indicators of COR1,COR2,COR3,CRH1,CRH2,CRH3,MLT1,MLT2 and MLT3（t=4.478,p<0.05）,the average level of COR3 was lower（t=-12.622,p<0.05）,and there was a significant statistical difference;the other indicators did not reach a significant difference.（3）Correlation of stress perception,sleep responsiveness and serological indexes: In CID group,only CPSS and PASCA indexes were significantly correlated with serological indexes.Among them,CPSS was positively correlated with CRH3（r=0.58）,and negatively correlated with MLT1,MLT2 and MLT3（r=-0.5;r=-0.58;r=-0.47）.PSASC was positively correlated with both COR2 and MLT3（r=0.45;r=0.38）.There was no significant correlation between the other indicators.（4）Correlation of pressure perception,sleep reactivity and sleep parameters: Only PSASB index was significantly correlated with sleep latency in CID group.PSASC was negatively correlated with sleep latency（r=-0.45）.There was no significant correlation between the other indicators.（5）Correlation between serological indexes and sleep parameters: CRH1,CRH2,CRH3,MLT1 and MLT2 indexes were significantly correlated with sleep parameter indexes in CID group,and other serological indexes except CRH3 could be correlated with sleep parameter indexes.Significant correlation.Among them,CRH1 was positively correlated with N2 and REM latency;negatively correlated with N1;negatively correlated with sleep latency.CRH2 was positively correlated with N2;negatively correlated with N1.CRH3 was positively correlated with N2.MLT1 was positively correlated with N1;negatively correlated with N2.MLT2 was negatively correlated with N2 and wake times.（6）Correlation of serological indexes: COR3 indexes in CID group were negatively correlated with CRH3.COR3 index was positively correlated with MLT2 in CID group.CRH3 index was negatively correlated with MLT2 in CID group.Conclusion:CID patients have increased morning cortisol secretion and decreased morning cortisol secretion,but no significant changes in melatonin,and their pre-sleep stress cognition and high arousal state are associated with objective sleep quality. |
PDF Full Text Request