高易感、中易感与低易感:军人睡眠反应性类别及其在情绪状态与睡眠质量关系中的调节效应OA
High,moderate,and low sleep reactivity:the 3 categories among military personnel and their moderating effects in the relationship between emotional states and sleep quality
目的 军人作为执行特殊任务的群体,其睡眠健康直接影响心理适应能力与战斗力.睡眠反应性是反映个体在压力或刺激下睡眠易损性的关键指标,然而现有研究多基于变量中心视角,忽视了军人群体中可能存在的睡眠反应性异质性亚型,且不同亚型在情绪与睡眠关系中的调节机制尚不明确.本研究探索军人睡眠反应性的潜在类别,分析不同类别在情绪状态与睡眠质量关系中的调节效应.方法 本研究采用横断面调查研究设计方案,不涉及前瞻性分组或干预处理.运用方便抽样法,于2025年3-4月,以某部1 352名军人为研究对象,运用福特应激性失眠反应测试、正性负性情绪问卷中的正性情绪分量表、抑郁焦虑应激问卷中的焦虑分量表、失眠严重程度指数(insomnia severity index,ISI)量表进行问卷调查.采用Spearman相关分析考察各研究变量间的相关性;采用潜在剖面分析探索军人睡眠反应性的潜在类别;采用方差分析法考察不同类别睡眠反应性军人在睡眠问题、正性情绪、焦虑上的差异;采用构建交互项的方法分析高、中、低易感组在正性情绪与睡眠的关系上的调节效应和焦虑与睡眠关系上的调节效应.结果 睡眠反应性与ISI总分呈显著正相关(r=0.546,95%CI:0.506~0.583,P<0.01)、睡眠反应性与焦虑呈显著正相关(r=0.390,95%CI:0.343~0.436,P<0.01),睡眠反应性与正性情绪呈显著负相关(r=-0.309,95%CI:-0.358~-0.259,P<0.01),ISI总分与正性情绪呈显著负相关(r=-0.348,95%CI:-0.396~-0.299,P<0.01);ISI 总分与焦虑呈显著正相关(r=0.454,95%CI:0.410~0.497,P<0.01);正性情绪与焦虑呈显著负相关(r=-0.364,95%CI:-0.410~-0.315,P<0.01).军人睡眠反应性可以分为高易感组、中易感组和低易感组3种类别,每种类别所占比例分别为6.0%,41.7%和52.3%;高易感组的ISI得分(均值差异:高vs低=7.217,95%CI:6.425~8.009,P<0.001;高vs中=5.047,95%CI:4.244~5.849,P<0.001)和焦虑得分(均值差异:高 vs 低=6.515,95%CI:6.209~6.819,P<0.001;高vs中=5.770,95%CI:5.461~6.079,P<0.001)均显著高于中、低易感组;中易感组的ISI得分显著高于低易感组(均值差异:2.170,95%CI:1.789~2.551,P<0.001);中易感组的焦虑得分显著高于低易感组(均值差异:0.745,95%CI:0.597~0.891,P<0.001);正性情绪得分上,高易感组显著低于中、低易感组(均值差异:高 vs 低=-16.905,95%CI:-18.114~-15.695,P<0.001;高 vs 中=-2.692,95%CI:-3.917~-1.466,P<0.001),中易感组显著低于低易感组(均值差异:-14.212,95%CI:-14.795~-13.630,P<0.001).与低易感组相比,高易感组的焦虑对睡眠的影响更大(β=-0.213,95%CI:-0.366~-0.059,P<0.01);在正性情绪对睡眠的影响中,正性情绪与中易感组交互项对ISI的回归效应不显著(β=-0.073,95%CI:-0.249~0.103),正性情绪与高易感组交互项对ISI的回归效应不显著(β=-0.145,95%CI:-0.383~0.093).结论 军人睡眠反应性可以分为低易感、中易感和高易感3种类别;与低易感军人相比,高易感军人的睡眠质量更易受焦虑情绪的损害.该发现提示,在军事心理卫生工作中,应重点关注高睡眠反应性军人的焦虑情绪管理,以降低其失眠风险.
Objective Military personnel,as a group executing special missions,have sleep health that directly affects psychological adaptability and combat effectiveness.Sleep reactivity is a key indicator reflecting an individual's vulnerability to sleep disturbances under stress or stimulation.However,existing studies have mostly adopted a variable-centered perspective,neglecting the possible heterogeneous categories of sleep reactivity within the military population,and the moderating mechanisms of different categories in the emotion-sleep relationship remain unclear.This study aims to explore the latent categories of sleep reactivity in military personnel and analyze the moderating effects of different categories on the relationship between emotional states and sleep quality.Methods A cross-sectional study design was adopted.A total of 1 352 military personnel from a certain unit were recruited as participants using convenience sampling from March to April 2025.The survey instruments included Ford Insomnia Response to Stress Test-Chinese Version(FIRST-C),Positive Affect Subscale from the Positive and Negative Affect Schedule(PANAS),Anxiety subscale from the Depression Anxiety Stress Scales(DASS),and the Insomnia Severity Index(ISI).Spearman correlation analysis was used to examine the correlations among the study variables;Latent profile analysis(LPA)was employed to explore the latent categories of sleep reactivity in military personnel;Analysis of variance(ANOVA)was utilized to compare differences in sleep problems,positive affect,and anxiety among military personnel with different categories of sleep reactivity.Interaction terms were constructed to analyze the moderating effects of the high,moderate,and low reactivity groups in the relationship between positive affect and sleep,as well as between anxiety and sleep,Results Sleep reactivity was significantly positively correlated with total ISI score(r=0.546,95%CI:0.506 to 0.583,P<0.01)and anxiety(r=0.390,95%CI:0.343 to 0.436,P<0.01),and also negatively correlated with positive affect(r=-0.309,95%CI:-0.358 to=0.259,P<0.01).Total ISI score was negatively correlated with positive affect(r=-0.348,95%CI:-0.396 to-0.299,P<0.01),and positively with anxiety(r=0.454,95%CI:0.410 to 0.497,P<0.01).Positive affect was negatively correlated with anxiety(r=-0.364,95%CI:-0.410 to-0.315,P<0.01).Sleep reactivity among military personnel could be classified into 3 categories:high,moderate,and low reactivity,accounting for 6.0%,41.7%,and 52.3%of the total participants,respectively.The high reactivity group exhibited significantly higher ISI scores(mean difference:high vs low=7.217,95%CI:6.425 to 8.009,P<0.001;high vs medium=5.047,95%CI:4.244 to 5.849,P<0.001)and anxiety scores(mean difference:high vs low=6.515,95%CI:6.209 to 6.819,P<0.001;high vs medium=5.770,95%CI:5.461 to 6.079,P<0.001)than both the medium and low reactivity groups.Compared to the low reactivity group,the medium reactivity group had significantly higher ISI scores(mean difference:medium vs low=2.170,95%CI:1.789 to 2.551,P<0.001)and anxiety scores(mean difference:=0.745,95%CI:0.597 to 0.891,P<0.001).Regarding positive affect scores,the high reactivity group scored significantly lower than the low and medium reactivity groups(high vs low=-16.905,95%CI:-18.114 to-15.695,P<0.001;high vs medium=-2.692,95%CI:-3.917 to-1.466,P<0.001),and the medium reactivity group scored significantly lower than the low reactivity group(mean difference=-14.212,95%CI:-14.795 to-13.630,P<0.001).The high reactivity group showed a greater impact of anxiety on sleep than the low reactivity group(β=-0.213,95%CI:-0.366 to-0.059,P<0.01).In the effect of positive affect on sleep,the interaction term between positive affect and the moderate reactivity group had no significant regression effect on ISI(β=-0.073,95%CI:-0.249 to 0.103),and the interaction term between positive affect and the high reactivity group also had no significant regression effect on ISI(β=-0.145,95%CI:-0.383 to 0.093).Conclusion Sleep reactivity among military personnel can be categorized into 3 types:low reactivity,moderate reactivity and high reactivity.Compared with the military personnel with low sleep reactivity,those with high reactivity have sleep quality more vulnerable to anxiety.This finding suggests that in military mental health practice,priority should be given to anxiety management for those with high sleep reactivity in order to reduce their risk of insomnia.
张琼月;许辰;徐晓晓;李美欣;杨艳贞
陆军军医大学(第三军医大学)大坪医院肾内科,重庆陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆||中国人民解放军第73106部队91分队,江苏淮安
医药卫生
军人睡眠反应性焦虑正性情绪潜在剖面分析
military personnelsleep reactivityanxietypositive affectlatent profile analysis
《陆军军医大学学报》 2026 (11)
1619-1628,10
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